Fire away other EMS-ers..

[SingleLovingLife]

I would think working in the environment of a casino, where patrons may be carrying large sums of money on their person, finding a "cooperative" medical who is packing would not be all that unusual ~ regardless as to whether or not it is within his legal rights. If you ever ran all your guests through a metal detector or did pat downs, you would probably be surprised as to how many are carrying weapons.

Although I'm surprised that "altered mental status" is not one of the criteria where you can be hands on with a patient. What if they are wearing some type of Medic Alert necklace or bracelet that is concealed by their clothing? Or if they have a card in their wallet/purse with medical information on it? Given the fact that everything is monitered by surveillance cameras, it would seem like you would be able to check for these things and have it on tape that your search was legitimate. Then you might see the big, shiny badge in their wallet, or the small caliber hand gun in their purse...whatever.

Given this incident, perhaps you could suggest that once it has been determined someone needs to be transported, officers/emt's be allowed to ask the patient/guest, "For the safety of those providing your care, we need to ask whether or not you are carrying any type of weapon?" Although, not knowing everyone else's laws concerning firearms ~ that question probably infringes on someone's rights somewhere.

Or, just institute a policy where anyone who gets transported has to get naked! JUST KIDDING!

Reminds me of my days working in retail...a nicely dressed gentleman came up to the customer service counter and asked the 19 year old clerk if he could leave something with her for safe keeping while he shopped. This is not an unusual request and she smiled and said, "Sure, no problem!" She was screaming for me a minute later ~ after he put his .357 on the counter and walked off! I thought she was going to have a stroke! It took me forever to calm her down and convince her she didn't need to go home sick. Found out later, he had a permit to carry ~ just didn't want anyone in the grocery store to "notice" it and call the cops. :roll:

[medic001918]

I'm curious about something. You found out that he was carrying a weapon, but you never stated if he was doing so legally or illegally? I carry sometimes (legally), and if I'm involved in some kind of medical event as a patient, don't expect me to tell you about it until we're somewhere where there aren't a ton of people around as that just might cause more of an alarm than not saying anything at all. Once you are told about it, it will be happily surrendered to a police officer ONLY and noone else (and that does include a uniformed security person with a CCW).

It sounds like your employer doesn't really want you to have the full limited capabilities of being an EMT-B in the first place since they limit how you can perform your assessments. Sounds like a sticky situation to be in that might hold some increased liability since you're hired to be an EMT, but not allowed to practice fully by the casino.

While the firearm was present, it doesn't sound as though he had any intent on using it so you probably weren't in as much danger as you thought you were. Looking at it that way, do you ever know how safe or unsafe you really are? At work or not? You never know who might be standing next to you carrying a gun, holding a knife, etc. I know I've done a few calls where it hasn't been an "inner city" guy that used a weapon in a violent manner; just as I've done plenty of calls where it was the "inner city" guy that had an act of violence performed against him. Like I mentioned, I carry sometimes and I usually dress in jeans that fit properly and a button down or t-shirt. You'd never know I had a firearm on me. That's part of the whole "concealed carry" issue. If it's concealed properly, noone is supposed to know you have it.

Maybe this call is a good reason to push for some protocol change and allow a little more hands on assessment? Or at least a search for the safety of the employees and the patrons of the casino.

[Asysin2leads]

Okay, the guy was AMS, and under no obligation to tell the truth, but a really good way to find out if someone is carrying a weapon them is simply to ask. Especially if its legally owned, if you make it clear you're simply asking from a safety stand point, a lot of people will answer honestly. It may sound naive, but it works.

My feeling is my life is a lot more important than my job, so if for whatever reason I think someone is carrying, they're not getting a ride to the hospital unless I'm confident they are no longer carrying. Heck, a lot of my patients have ended up at the hospital with cut pants pockets if I'm afraid they have something sharp in there. Legal or illegal, unless they are a licensed LEO, no one carries a loaded gun in an ambulance I'm riding on. AMS + firearm = dead EMT. The first rule of EMS is if you don't feel safe, don't be there.

[Asysin2leads]

Okay, I found this clip today which pretty much backs up my point about never being too careful. I'm not posting this for shock value or gross out points, I really believe people can learn from this video. I need to warn you it can be very disturbing, but then again if you can't handle something like this, you're probably in the wrong field. But, be forewarned, and if you are minor or easily offended, DO NOT WATCH.

Now for the adults in the audience who want to learn about how quickly a situation can go bad...

http://s36.photobucket.com/albums/e7/dla40...ADSEARCHwmv.flv

[Aleks]

We are allowed to search all individuals, after all its our safety....its at our discretion, but I've had pockets emptied, book bags emptied, you name it, if the situation warrants.....I'm a little concerned when the medics missed it, thats their job to assess....they obviously shit the bed there...

[Ridryder 911]

Very awakening video Ays.. makes a good point, that all patients should be patted down and never ASSUME anything. One of the most dangerous situation I was placed in was from an 80 year old granny.. who wanted her purse to check to see if she had her medicare card. She did as well as a .38 caliber, in which she pointed at me .. and demanded we not take her to the nursing home.... we didn't. I never hand purse, medication bag(s), etc, without searching first, and I attempt to "patt" all patients down 1'st. I can't tell you how many patients arrive in ER "packing" ...

Be safe,

R/r 911

[Savoy6]

It happens, as feces does occur. An increased pucker factor is a good learning tool. As anything else, learn from the call.

I used to teach assessment a different way than most instructors. I'd hide actual weapons on the patient. Bayonets, grenades, full size 92F. Got missed by the whole class.

An assessment is not a search, it's meant to find problems not weapons.If you do find something,scene safety, right. Semantics, yes, but assessment is a tool we have to treat patients. Altered level of conciousness can hide a medical condition or injury. How you sell your assessment is the key. Let the caregiver in you take over, not the security guard. Bedside manner, schmooze. Once force takes over, as it does sometimes, that old slippery slope comes up.

I knew a guy that stripped all AMS females under the guise of looking for weapons. Yeah, right. You use the amount for the situation, reasonableness is the key.

I know i wandered off topic but you have to protect yourself on the scene and after the call.

A search is a completly different topic. That darned 4th amendment (sarcasm)

[whit72]

Safety is my main concern. If I believe you are carrying a weapon you are going to be searched, patted down, call it an assessment if you need to. If that impedes on your civil rights, call the ACLU. You are not getting in my ambulance with a weapon unless you have a badge to go along with it. Even in that case I will try to secure it with another police officer. It only takes one instance to end, or severely impair your life. I'm not willing to take that chance.

I do care about your rights, however I have the right not to be stabbed, shot, assaulted or stuck with dirty needles(we cut pockets also) while in the process of doing my job.

If I feel threatened at any point my rights trump your rights.

[Savoy6]

Safety is my main concern. If I believe you are carrying a weapon you are going to be searched, patted down, call it an assessment if you need to. If that impedes on your civil rights, call the ACLU. You are not getting in my ambulance with a weapon unless you have a badge to go along with it. Even in that case I will try to secure it with another police officer. It only takes one instance to end, or severely impair your life. I'm not willing to take that chance.

I do care about your rights, however I have the right not to be stabbed, shot, assaulted or stuck with dirty needles(we cut pockets also) while in the process of doing my job.

If I feel threatened at any point my rights trump your rights.

1. I believe you may have missed my point. All people should be assessed. All should be suspected of not only having a weapon, but any underlying injuries or medical problems. It all goes together. BUT, emotion does not trump, as you say, the law or a person's rights. I'm not going to get in a pissing contest, but read case law against law enforcement. They can't search, just to search, but we can assess a patient, that is part of the job. But there has to be reasonableness in your actions. When studying searches read about looking for an elephant in a shoe box.

Each situation is different as is your approach. That is what you are judged on. Simple fact. You can't strip people or cut everyone's clothes off and declare "scene safety". When you are brought up on a civil rights violation, it isn't so easy to just say it was for my safety. And to say it doesn't happen, it does. Civil right violations are a federal case, employers don't like to go there and you might be swinging alone. Oh, it sounds good, but it won't hold up in court.

2. A weapon is not just what you find on the person, but what is within their reach, including that stethoscope around your neck, that knife in your pocket, many things in your rig. Don't give them that opportunity either. Safety starts from the time you get the call until you are back in the station, or on your arrival at home, alive post shift.

3. Since this lock step teaching of this "scene safety" crap, (I use the term crap to describe the way it's taught, not the concept).students respond like Pavlov's dog or a parrot, 'scene safety"- Ask them to explain it and dollars to donuts they'll say, "I was trained to say it to pass the practical station". give them a scenario and when they say, "is the scene safe?", tell them, NO. See what happens, the train of thought derails.

new students and refresher students should be taught actual cases, and rational, legal responses. if not you are at risk responding with a poorly trained partner or you are poorly trained and equipped.

Case in point- patient spits in paramedics face, paramedic punches patient. legit?? Well, the patient was on a long-backboard, immobilized, and was 16.

Defend that action

[PRPGfirerescuetech]

So, in reality, we are not permitted to "search" a patient, but we should be adequately "assessing" all patients.

Interesting concept.

</sarcasm>

I must ask, cutting pockets whit? For all patients? Searching them? How do you decide who gets searched?

Nevermind, dont answer that. Its a civil rights violation no matter how you cut this.