Patients, Guns, and EMS

[scubanurse]

I was driving home in the pouring rain this evening and was thinking... not usually a good combination, but tonight, I had a question that I'm not entirely sure the answer to.

In Colorado as in many other states, certain people can carry a gun concealed. I happened to be carrying tonight at the time I thought of this. If I were in a wreck, unconscious and unable to inform the providers, you backboard me and in the process of assessment find the gun. What would you do? My hopes would be to discover the gun while still on scene with LEO's a plenty and can hand off the gun to the officer....but what if you didn't... I carry inside the waist band and so it may not be felt on initial assessment, especially a rapid trauma/extrication.

I only practiced in a state where CCW was non-existant so I was never posed this question in training or came upon it during my experiences. I know we have a few CO providers and a few TX providers, both states that allow CCW and both states where most people do.

Opinions?

[PCP]

I was driving home in the pouring rain this evening and was thinking... not usually a good combination, but tonight, I had a question that I'm not entirely sure the answer to.

In Colorado as in many other states, certain people can carry a gun concealed. I happened to be carrying tonight at the time I thought of this. If I were in a wreck, unconscious and unable to inform the providers, you backboard me and in the process of assessment find the gun. What would you do? My hopes would be to discover the gun while still on scene with LEO's a plenty and can hand off the gun to the officer....but what if you didn't... I carry inside the waist band and so it may not be felt on initial assessment, especially a rapid trauma/extrication.

I only practiced in a state where CCW was non-existant so I was never posed this question in training or came upon it during my experiences. I know we have a few CO providers and a few TX providers, both states that allow CCW and both states where most people do.

Opinions?

That is crazy that you folks can carry a gun!!

[BAYAMedic]

My hopes would be to discover the gun while still on scene with LEO's a plenty and can hand off the gun to the officer....but what if you didn't... I carry inside the waist band and so it may not be felt on initial assessment, especially a rapid trauma/extrication.

This topic came up in my basic class and lead to a very interesting discussion. I carry off the job, and consider myself proficient with a variety of firearms. But a LEO is going to be more proficient, as well as having the proper equipment to clear the weapon. So correct, they would be the best carrier of the weapon, as weapons are expressly forbidden at local hospitals and I am not comfortable leaving someones CCW in there car to be towed.

The next issue is the very atypical patient, The US Marshall. They are trained to never surrender their weapon to anyone, for any reason. With such intense training ingrained into them for years, I fear you would have a rodeo on your hands if you tried to disarm said officer if they had an altered LOC. I really don't have a good answer for this, but it was something that came up in class.

Lastly, I am a bit concerned on the thought of it not being discovered on initial/rapid trauma assesment. I carry In Waistband Strong side, and it would be discovered as I checked pelvic stability, Appendix carry during ABD palpation, Or Small of back carry during log roll inspection or KED placement. Ankle Carry during extremity checks. My thoughts are if you were to miss a Weapon during the Initial Assesment/Rapid Trauma, How many other things are you going to miss.

Fireman1037

[Bieber]

If we were still on scene, and it wasn't a time sensitive injury, I'd call PD and hand the weapon off to them. If we needed to book it for the sake of the patient's wellbeing, or if we were already en route, I'd put it in the lockbox with our narcs and advise PD to meet us at the receiving facility.

On a side note, towards the end of last year I took part in some EMT training where I played an armed patient. My goal was to get the gun into the back of the ambulance without them noticing, which I managed with only one group out of four.

On the down side, all of the groups failed to properly take into account that it was nearly freezing out, and they all cut my shirt off for their assessment (which inexplicably took precedence over moving my hypothermic and hypovolemic ass into the truck), and had both extended scene times and a chronic failure to put a blanket on the spine board before they put me on it. I explained to them afterwards that if I, a perfectly healthy young guy whose body was NOT riddled with bullet holes, was growing ever closer to hypothermia due to their extended scene times and failure to take the environment into account, they could bet their ass that a patient who's bleeding internally would suffer even more serious consequences from that kind of error. Hopefully it was a learning experience for them!

Returning to the topic, I'm grateful to have never had any kind of weapon drawn on me yet, and to have never found one on any patient either. The closest to violence I've ever come was getting kicked and punched by an ill patient--but never fear, I suffered only a bruise to my pride.

Edited April 14, 2011 by Bieber

[FireMedic65]

Well, a good assessment you reveal you had something on you. A rapid trauma assessment takes not long at all and would discover the weapon.

If PD was there, sure, have them remove the gun.

No PD, I would not leave the weapon there. I would inform PD I discovered a concealed weapon and consult on how to remove it and clear it from danger (I know how to do this already but it sounds better over the radio). PD would most likely meet me at the hospital and secure that weapon.

Or you could just put a sticker on your window

[scubanurse]

If we were still on scene, and it wasn't a time sensitive injury, I'd call PD and hand the weapon off to them. If we needed to book it for the sake of the patient's wellbeing, or if we were already en route, I'd put it in the lockbox with our narcs and advise PD to meet us at the receiving facility.

So you would handle an unknown weapon? What if it discharged while in your "custody"?

[Happiness]

My first question Kate why do you carry a gun. Im asking because in my mind people that are in fear, live in a place where there is alot of violence, or hunt carry guns. I cant fathom a young lady like yourself carring a gun without reason. And Im not asking to make it an issue its just a plain question.

So I guess to answer your question I would hope that I would catch a gun in my RBS as it would be a bit more intense if it was a MVA. Now you stated that you carry it in your belt and if I was good at my RBS Im going to make sure that I check around the seatbelt area for instabilty in the pelvic area so therefore I would hope to find it and hope to hell it has the safty on If I found a gun on someone I would carefully remove it and yes give it to an RCMP officer. Now with that being said I have been to scenes without the RCMP present so in that case I would have to call dispatch and inform them of the firearm and you know I dont really know where I would put it but I do know that it wouldn't be in my ambulance.

This is a real good question and has made me think about it thanks kate

[paramedicmike]

I discovered a Glock 9mm on a patient after an auto accident. Fortunately, we were still on scene and police were close by. I simply called over the officer, pointed to the weapon and let the cop remove/unload it.

Two of my coworkers at one point, however, completely missed the weapon. It was discovered upon transfer of care in the trauma bay when a tech removed the patient's cut jeans from the board and the pistol hit the floor. They had a hard time explaining that one. The tough part was that they actually did a pretty thorough assessment. Clothes had been completely cut and the patient was trauma naked. To this day they're still not sure just where it had been concealed.

[FireMedic65]

I discovered a Glock 9mm on a patient after an auto accident. Fortunately, we were still on scene and police were close by. I simply called over the officer, pointed to the weapon and let the cop remove/unload it.

Two of my coworkers at one point, however, completely missed the weapon. It was discovered upon transfer of care in the trauma bay when a tech removed the patient's cut jeans from the board and the pistol hit the floor. They had a hard time explaining that one. The tough part was that they actually did a pretty thorough assessment. Clothes had been completely cut and the patient was trauma naked. To this day they're still not sure just where it had been concealed.

Sure you want to know?

[Dustdevil]

If we were still on scene, and it wasn't a time sensitive injury, I'd call PD and hand the weapon off to them. If we needed to book it for the sake of the patient's wellbeing, or if we were already en route, I'd put it in the lockbox with our narcs and advise PD to meet us at the receiving facility.

Excellent reply.

As a police officer, I was once in an MVA in my personal vehicle off-duty. Being very close to home, both the responding fire and EMS crews were friends of mine. I didn't know the cop though, and although he had my driver licence, I had not ID'd myself as an officer to him. As they were beginning to extricate me, I told the fire crew that I had a gun under my jacket. The fire lieutenant -- a good friend -- asked if I'd like him to just take it back to his station and lock it up for me, rather than the hassle of retrieving it from the police property room. Sounded good to me, so I handed it to him and told him there were three more in the trunk. It was priceless watching the look on the cop's face as the fire lieutenant started pulling an M-16 and a shotgun from my trunk! FD explained it to him, and he confirmed with me that it was okay with me, and all was good.

But the point is, if there is a competent adult that the patient is comfortable releasing his weapon to, licensed or unlicensed, then I would certainly allow my patient that option, not insisting on police involvement. Even cops do that with cars in order to spare someone towing charges after an arrest. So, unless you have a specific law or policy prohibiting it, that's an option to consider. But regardless of policy or laws, don't let yourself be talked into anything you are seriously uncomfortable with.

Edited April 14, 2011 by Dustdevil