Patients, Guns, and EMS

[JPINFV]

I think the idea that we are not trained to handle guns comes into play here. Does a basic know how to intubate through practicing on the dummies at the station? Maybe, does that mean they can safely do it in the field? Possibly, does that mean they should? Not likely.

I have grown up around guns, I can clear probably 99% of the guns you will find in the public without hesitating to figure it out. But while on duty as a paramedic/emt/ambulance driver, that is not in your job description.

I think that comparing handling a fire arm with a restricted medical practice is comparing apples to oranges. If we want to go the job description route, I've helped push a few cars out of the road while on duty and not on a car. I guess I shouldn't have since clearing road ways aren't in my job description or scope of practice. I guess I should have left that to the police or tow truck companies. Clearing roads of simple broken down cars has about as much to do with a restricted medical practice as clearing a fire arm.

Additionally, I agree that EMS providers who are not familiar with fire arms should not be handling them. However not everyone is not familiar with fire arms.

In my opinion after speaking to a few different cops who have POST certs, they recommend leaving in place, calling enroute to hospital and the police officer removing the weapon prior to bringing into the hospital.

Most CCW are holstered and so sometimes better left in place, and if we have to remove for patient care, they suggested if police were not on scene or in the unit, to remove the holster as a whole and lock in the lock box.

What you have to do is think almost worst case scenario. Yes this person is hurt, but was this gun used in a crime? If so, chain of custody plays a big role in what you do with the weapon.

I agree that leaving in place is the best option for a person who is legally carrying a fire arm. How many EMTs are going to let anyone, legally carrying or not, keep control of their weapon? I suspect very few will do so. Additionally, if the patient is altered or unconscious, then they aren't in control of their weapon, thus the situation is such where no one is in control of the weapon if left in place. I find a situation where no one is in control of a loaded (and it's loaded until cleared by default) to be much more dangerous that having a person with a CCW retaining control of their weapon.

As far as the fire arm being used in a crime, if the patient is legally carrying, then my first assumption is not going to be that the fire arm was used in a crime any more than I'm going to assume that a insulin dependent diabetic with an injection kit is actually some sort of drug dealer because the patient has syringes and needles with them. If the patient is not legally carrying, then my first concern is separating them from their fire arm or my partner and I from the criminal (not necessarily in that order). At that point, my concern for my safety over rules any concern over chain of custody. To clarify that last point, I do not consider someone who is legally carrying a fire arm to be a threat to my life. Hence the lack of a need to separate myself from a patient, or the patient's fire arm from the patient of an alert and oriented patient who has a valid CCW.

[Richard B the EMT]

I had only one scene where my patient was armed. While doing a patient evaluation, I stopped, and, as PD was on the scene, I invited the nearest one into the ambulance. Turned out the patient was an undercover LEO, and he surrendered the piece to the uniformed officer, who then called the LEO supervisor over. The LEO sarge had custody of the weapon last I saw of it.

[JPINFV]

I have a cousin that was raped very violently 20 years ago. Her and her family were going home from a family dinner in their neighbourhood. Warm summer evening, they stopped at the sign and some guy was in bush. He ran up and put a gun to her head, dragged her out of the car, yelled at the husband that if he moved she would be killed. This man raped her and then he ran off. They went and did all the after stuff with the hospital and cops. They did catch the guy and to this day he is still in jail. When her father found out about the attack he went and bought her a gun. She never carried it even though she was good shot and had learned how to use it and the reason she didnt is because she honestly didn't think it would have made a difference. She is a pretty amazing lady and to this day still goes to parol hearings to keep this guy in jail and she say's her story.

I dont think it is wrong if it makes you feel safe, but I guess I just dont get it.

What if someone else in the family was carrying?

What if a by-passer was carrying and could have stopped it?

Did she carry her head high before hand? If she did (and I hope she did then and hope she does now), it didn't do her a lick of good deterring the attack.

Also, apparently the police did a real good job of protecting her, correct?

Also, such a lick of good that entire "shared values" glib did in keeping her safe.

[BAYAMedic]

Additionally, I agree that EMS providers who are not familiar with fire arms should not be handling them. However not everyone is not familiar with fire arms.

Familiar, and expert in use and handling are two entirely different items. I am not an Armorer or a Gunsmith. I don't know the trigger pull on every weapon out there, let alone someone who has been chopping, filing or otherwise modifying a "stock" weapon. Some weapons but have the magazine locked in to rack the slide while others do not. I am proficient with many on the market today but if I have the slightest question about it, I am not going to assume the risk/liability. The special equipment I referred to is the trunk mounted clearing tube in their cruiser that in the event of accidental discharge the projectile is contained.

I agree that leaving in place is the best option for a person who is legally carrying a fire arm. How many EMTs are going to let anyone, legally carrying or not, keep control of their weapon? I suspect very few will do so. Additionally, if the patient is altered or unconscious, then they aren't in control of their weapon, thus the situation is such where no one is in control of the weapon if left in place. I find a situation where no one is in control of a loaded (and it's loaded until cleared by default) to be much more dangerous that having a person with a CCW retaining control of their weapon.

Agreed thats why law enforcement should take custody. Have you never had a patient have a change of level of consciousness over the duration of the call? In the OP, the person was in a car wreck. What if they had a brain bleed and became combative?

If the patient is not legally carrying, then my first concern is separating them from their fire arm or my partner and I from the criminal (not necessarily in that order). At that point, my concern for my safety over rules any concern over chain of custody. To clarify that last point, I do not consider someone who is legally carrying a fire arm to be a threat to my life. Hence the lack of a need to separate myself from a patient, or the patient's fire arm from the patient of an alert and oriented patient who has a valid CCW.

Wow, your "first concern" is separating them from their weapon. (or fleeing totally appropriate, no question) Last time I checked, my first concern is my patient who is injured or else I would not have been called to this scene. In the original post it is in regards to discovery of a weapon during patient care. None of my weapons have bright flashy lights that turn on when they have been used in a crime nor do I have my concealed carry permit tattooed to my chest. How exactly do you expect to differentiate the legal vs. illegal carrying of a weapon with out compromising patient care? We have a professional relationship with LEO's for mutual benefit.

Fireman1037

[Happiness]

What if someone else in the family was carrying?I probably should have stated this but her family were her husband and baby. So I dont think it would have helped. The husband felt alot of guilt after this as anyone would. I should have done more but in reality he did what he was told and she came out of it alive.

What if a by-passer was carrying and could have stopped it?You should know the gun was to her head the whole time as she says, so I still dont think that would have done any good, she would probably be dead.

Did she carry her head high before hand? If she did (and I hope she did then and hope she does now), it didn't do her a lick of good deterring the attack. She has always held her head high. My statement was a person walking down the street. You either look like a victim or you dont. In this case she was in the passanger seat of her car so your right it didnt do her a lick of good

Also, apparently the police did a real good job of protecting her, correct? I really dont understand this question. But unless you have a police officer with you 24/7 how could they protect her? Did they do a good job in catching the guy she has never said either way.

Also, such a lick of good that entire "shared values" glib did in keeping her safe.

You obviously miss understood this statement. We Canadians and You americans share a lot of moral values like we want to see bad guys punished, we want the best for our children, we try to be good people. Not that there not other counties that share our value system before that becomes a issue.

So you could what if this story or any other story to death. Oh and I dont think this was mentioned but my cousin lives in the Seattle area. And like I said before I dont think this is wrong I just dont understand it because I dont have to live in a place where I would have enough fear to have to carry a gun. But as I had asked Kate I was just amazed at the fact that at her age she felt the need for a gun to feel safe. She said she had her reasons and I accepted that. In Canada and I dont know why but in reality only Cops and Bad guys feel the need to carry. It is not a normal thing for the average joe.

Well pager just went off hope this answers your what ifs.

[JPINFV]

Familiar, and expert in use and handling are two entirely different items. I am not an Armorer or a Gunsmith. I don't know the trigger pull on every weapon out there, let alone someone who has been chopping, filing or otherwise modifying a "stock" weapon. Some weapons but have the magazine locked in to rack the slide while others do not. I am proficient with many on the market today but if I have the slightest question about it, I am not going to assume the risk/liability.

How much risk and liability are you assuming by having a loose and loaded fire arm laying around?

Agreed thats why law enforcement should take custody. Have you never had a patient have a change of level of consciousness over the duration of the call? In the OP, the person was in a car wreck. What if they had a brain bleed and became combative?

The vast majority of my patients have not changed consciousness over the duration of the call. Not everyone taking a ride in the ambulance have been in a car wreck or at any sort of risk for becoming combative or losing consciousness. How quickly, to whom, and where should they, if they are legally carrying, surrender their fire arm? How long are you willing to wait on scene for PD to treat and/or transport if the patient is disarmed regardless of the complaint or their status? What sort of liability is there to refuse care to someone who is exercising a legal right? Similarly, why would someone who carries surrender to anyone besides family, trusted friends, or police?

Wow, your "first concern" is separating them from their weapon. (or fleeing totally appropriate, no question) Last time I checked, my first concern is my patient who is injured or else I would not have been called to this scene. In the original post it is in regards to discovery of a weapon during patient care. None of my weapons have bright flashy lights that turn on when they have been used in a crime nor do I have my concealed carry permit tattooed to my chest. How exactly do you expect to differentiate the legal vs. illegal carrying of a weapon with out compromising patient care? We have a professional relationship with LEO's for mutual benefit.

Fireman1037

Last time I checked, my first concern was for my safety, followed by my partner's safety, followed by bystander safety, followed by the patient's safety. The question is, now, is the man with the gun a danger to my safety or not. I reject the notion outright that a man with a gun is, by default, a threat immediately necessitating evacuation (otherwise every time the police show up evacuation would be needed). What are you going to do if you discover a firearm during a physical exam? Drop everything and run? How does that not compromise patient care?

Have you thought that, just maybe, the demeanor of the patient would play a role in determining legal/illegal status of a conscious adult? If police are not on scene, what are you planning on doing during the minutes it takes for the police to respond?

[JPINFV]

I probably should have stated this but her family were her husband and baby. So I dont think it would have helped. The husband felt alot of guilt after this as anyone would. I should have done more but in reality he did what he was told and she came out of it alive.

Could and should he have done more? Probably. Should he have felt guilt? Definitely not. I'm willing to bet that when it happened his brain switched off and the last thing he was able to do was think logically and make decisions on the fly about it.

You should know the gun was to her head the whole time as she says, so I still dont think that would have done any good, she would probably be dead.

She would have equal chance or more at staying alive though. After all, what if the police walked up during the crime? I doubt that they would have just sat around waiting anymore than the slightest opening for a clear shot. To say that it's better to do nothing while waiting for the police during an active crime would be the same as saying that the police shouldn't be called at all until the crime is complete. After all, if he is that dangerous, he isn't going to just submit to the police when they arrive. As I mentioned earlier, do not take this as a slam against the husband. Being present when a crime is initiated and coming in half way through are two different situations and the person coming in half way through should have a clearer head on their shoulders.

I really dont understand this question. But unless you have a police officer with you 24/7 how could they protect her? Did they do a good job in catching the guy she has never said either way.

If the police's job is not to protect us or they are unable to do so, then we should be able to take proactive steps, including the ability to carry weapons (including, but not limited to things like pepper spray, bludgeons, and yes, fire arms). After all, the criminals don't care about what the law says they can or can't carry, and even the nicest areas suffer major crimes from time to time. Preparedness is about what might happen, not what is expected to happen. I have health and auto insurance, yet I don't expect to be in a car accident or sick anytime soon. If I could legally conceal carry, I would not because I feel that there is an active threat against me, but because I can be a victim of a major crime, regardless of where I am.

She has always held her head high. My statement was a person walking down the street. You either look like a victim or you dont. In this case she was in the passenger seat of her car so your right it didnt do her a lick of good

Which is my point. Standing tall and acting not like a victim waiting for an attack isn't going to save someone from bad timing or random acts. If I came across someone being raped or assaulted, I'm not sure if I could just stand back waiting for the police to arrive after calling 911.

You obviously miss understood this statement. We Canadians and You americans share a lot of moral values like we want to see bad guys punished, we want the best for our children, we try to be good people. Not that there not other counties that share our value system before that becomes a issue.

Going back and rereading what was written, I did misread that, and I'm sorry about that.

So you could what if this story or any other story to death. Oh and I dont think this was mentioned but my cousin lives in the Seattle area. And like I said before I dont think this is wrong I just dont understand it because I dont have to live in a place where I would have enough fear to have to carry a gun. But as I had asked Kate I was just amazed at the fact that at her age she felt the need for a gun to feel safe. She said she had her reasons and I accepted that. In Canada and I dont know why but in reality only Cops and Bad guys feel the need to carry. It is not a normal thing for the average joe.

I don't think Seattle vs Canada matters as the issues about criminals not caring about what the law says and the police's inability to actively protect citizens is the same regardless of the side of the border.

[BAYAMedic]

How much risk and liability are you assuming by having a loose and loaded fire arm laying around?

I have stated, PD will take custody of said weapon

The vast majority of my patients have not changed consciousness over the duration of the call. Not everyone taking a ride in the ambulance have been in a car wreck or at any sort of risk for becoming combative or losing consciousness. How quickly, to whom, and where should they, if they are legally carrying, surrender their fire arm? How long are you willing to wait on scene for PD to treat and/or transport if the patient is disarmed regardless of the complaint or their status? What sort of liability is there to refuse care to someone who is exercising a legal right? Similarly, why would someone who carries surrender to anyone besides family, trusted friends, or police?

Agreed, they would voluntary surrender one one of the above. If they are going to be treated by me, then they are going to the hospital, Where firearms are prohibited. They now have the choice of leaving it at there home,where I responded, they could leave it with spouse or friends, if out in the community. Or in the event of a car wreck, with Law Enforcement. I have never been to a car wreck where injuries were involved, where I cleared the scene before PD arrival, therefore not stalling PT care.

Last time I checked, my first concern was for my safety, followed by my partner's safety, followed by bystander safety, followed by the patient's safety. The question is, now, is the man with the gun a danger to my safety or not. I reject the notion outright that a man with a gun is, by default, a threat immediately necessitating evacuation (otherwise every time the police show up evacuation would be needed). What are you going to do if you discover a firearm during a physical exam? Drop everything and run? How does that not compromise patient care?

I would very calmly inform the patient that I see that he/she is carrying and that the hospital forbids it. Would you like to leave it with the officer over there or with your spouse/friends. Then document it in my chart, just as I would with any other valuable. As stated in previous posts, I myself carry off the job, I don't have the "Holy crap a man with a gun" mentality. I just know that my job as a Emergency service provider doesn't give me the tools to deal with this regularly enough to be fully expert in all weapons. If they are with it enough to make a decision of where to leave it, I would offer that to them, If not, I am using my best judgement to leave it with the most appropriate person of responsibility.

Have you thought that, just maybe, the demeanor of the patient would play a role in determining legal/illegal status of a conscious adult? If police are not on scene, what are you planning on doing during the minutes it takes for the police to respond?

I can manipulate perceptions of myself to best suit my needs provided I am not severely altered. I credit my patients the same abilities. I also can reason with them and I have the ability to run like hell if need be. They called me there for a reason, I can address the reason for the call and buy time until police involvement. Do you not have radio language in your local area that translates to "I'm trapped in a bad situation but cannot elaborate on the radio, send help to last known location."

Fireman1037

[Bieber]

The vast majority of my patients have not changed consciousness over the duration of the call. Not everyone taking a ride in the ambulance have been in a car wreck or at any sort of risk for becoming combative or losing consciousness. How quickly, to whom, and where should they, if they are legally carrying, surrender their fire arm? How long are you willing to wait on scene for PD to treat and/or transport if the patient is disarmed regardless of the complaint or their status? What sort of liability is there to refuse care to someone who is exercising a legal right? Similarly, why would someone who carries surrender to anyone besides family, trusted friends, or police?

With all due respect to the rights of other people, and the rights granted by the Constitution, NOBODY without a badge is bringing their gun into my ambulance under any circumstances. The right to bear arms doesn't allow you to carry wherever you go, and my safety comes first and foremost. I'd have to check, but I'd be willing to bet it's in the policy manual somewhere as well.

Last time I checked, my first concern was for my safety, followed by my partner's safety, followed by bystander safety, followed by the patient's safety. The question is, now, is the man with the gun a danger to my safety or not. I reject the notion outright that a man with a gun is, by default, a threat immediately necessitating evacuation (otherwise every time the police show up evacuation would be needed). What are you going to do if you discover a firearm during a physical exam? Drop everything and run? How does that not compromise patient care?

I'm not saying they're a threat, I'm saying I don't know, and I'm not putting myself or my partner in the back of an ambulance with a dangerous weapon. We don't know our patients, we don't know whether they're law-abiding or criminal, and we don't know what their intentions are. They may be good, they may be bad. For my safety, the safety of my partner, and the safety of my patient, they're not bringing a weapon with us to the hospital. They can lock it up, give it to a family member, or turn it over to the police, but neither the ambulance nor the hospital is a place for people to bring their weapons.

Have you thought that, just maybe, the demeanor of the patient would play a role in determining legal/illegal status of a conscious adult? If police are not on scene, what are you planning on doing during the minutes it takes for the police to respond?

Be vigilant, be ready to run, and keep a very close eye on the patient. If they start acting like they mean to cause me or my partner harm, we take part in the time honored tradition of making a "strategic retreat". Otherwise known as running away like little the unarmed, unarmored folks we are.

[usalsfyre]

What's humorous is how many people think LEOs are magically qualified to render a firearm "safe". Many LEOs are barely qualified to work their own gun, much less another make/model.

In a former life, before kids and career I did a fair bit of high level competitive shooting. My family is still heavily involved, those of you watch the shows about competitive handgun shooting on the Outdoor channel, ect would probably recognize my brother. I've handled literally hundreds of different types of firearms. Making them "safe" comes down to one thing, VISUALLY ensuring no ammunition remains in the gun.