ballistics vests for EMS providers?

[njmedic1485]

We carry three on each truck in external carriers, staff wear them as they feel the need. I just used to put one on scratrat and use him as a shield

[AnthonyM83]

of course a ballistic vest can save your life but they also add an intense amount of trapped body heat so if you are a "hot" person expect to be 20 degrees warmer.

I used to wear a vest over 40 hours a week in the summer and there's no way it increased temperature 20 degrees...maybe i just don't radiate that much heat, but that seems extreme. You forget you're even wearing one after awhile, like a seatbelt.

[captainstandup]

If societal decay has reached the point that we need body armor, perhaps it's time we arm paramedics with at least an airlight .38 with safety slugs.

I agree that we probably would be safer with body armor but if I must routinely wear it to respond to help someone, perhaps I shouldnt be there in the first place. As a rule I'm staging until it's as safe as possible regardless of how many victims or their severity. The cops are the only group that is prepared to defend itself and I'm not bringing a jumpbag to a gun or knife fight.

I think its interesting that during the most dangerous times in my life (on an ambulance) I have been disarmed by political correctness, liberal laws, and myopic policies. There are neighborhoods in America that are nearly as dangerous as Baghdad. Among the worst are South Miami, Washington DC, Houston TX, LA, Philadephia yet we expect non law enforcement personnel to rely on the fact that "we are there to help" and perhaps body armor to save us. This tune has a nice beat, but I think it may be hard to dance to........................

[Doczilla]

We generally account for an additional 10 deg F added to the WBGT for body armor. Laminate vest materials (Spectra, GoldFlex) have greater evaporative resistance and are perceived subjectively as hotter by wearers than the woven kevlar or twaron vests. I would recommend against soft laminate body armor for a number of reasons. Plate armor is probably unnecessary for the type of threats you will typically face.

I agree that there is no reason to pay $1000 for body armor unless you are on a SWAT team and are wearing a vest rated for those types of threats. A concealable level II or IIIa vest will run you no more than $500US, and usually is considerably less. And it's a lot less conspicuous to the viewer than one of these "EMS vests". The EMS vests add some functionality in that they can carry gear in all the little pouches, but with the difference in price, you have to wonder if you're paying an additional $500 on top of what you'd spend for body armor to carry stuff that you could carry in a $100 load bearing vest.

Your local police department likely has a contract with a uniform shop for their vests. Go there and get fitted, as they will have the knowledge to fit you properly and will have mock-up vests for you to try on. They may honor the negotiated price that they charge the police.

My recommendation is to buy your own and buy it brand new. That way you know how it has been treated and cared for and how much use it's had. I realize this is difficult on an EMT-B salary, and would require a substantial amount of savings. A false sense of security is really no security at all.

'zilla

[Richard B the EMT]

I have to go through my records, but I think I remember only paying $90.00 (USD) for the external wear carrier. And at those prices, so what if it's $90 or 100 dollars? The 10 buck difference isn't gonna break your bank, is it?

[AnthonyM83]

If societal decay has reached the point that we need body armor, perhaps it's time we arm paramedics with at least an airlight .38 with safety slugs.

Probably, but body armor has less chance of people getting into trouble with it.

I agree that we probably would be safer with body armor but if I must routinely wear it to respond to help someone, perhaps I shouldnt be there in the first place. As a rule I'm staging until it's as safe as possible regardless of how many victims or their severity.

You must routinely wear your seatbelt to respond to help someone, too... should you not be in there in the first place, too, then?

And since we're on the topic of crashes, there's a real danger of death or injury from an ambulance crash, so you're taking a risk anyway....and so happen the vest can help reduce serious bodily injury or even death in TCs. Take it from Dust and several others.

[captainstandup]

There is a vast difference between the need for a seatbelt versus the need for body armor. I realize we are talking about worse case scenarios here and perhaps body armor is a good idea. The idea of going into what is essentially a combat zone unarmed is unacceptable silliness. I'm not going to take unacceptable risks for myself or my partner regardless of the number or severity of victims. Our families have a right to expect our safe return from work, even if this means we stage until the scene is secure, always, 100% of the time. If this means victims die, then so be it. Better them than me. Dead heroes are still dead, and can never take their kids fishing or enjoy the wonderful things life has to offer.

I think the best case for body armor is for that percentage of calls where the violence is unknown, or at least the potential is unknown. Anthonym83 is correct in adding TC's to the discussion. I read, a long tome ago, an account of a ballistic vest saving a cops life from an MVA where there was intrusion of a foreign object into the vehicle and the breast plate deflected it away from penetrating the officers chest wall.

[AnthonyM83]

The idea of going into what is essentially a combat zone unarmed is unacceptable silliness. I'm not going to take unacceptable risks for myself or my partner regardless of the number or severity of victims. Our families have a right to expect our safe return from work, even if this means we stage until the scene is secure, always, 100% of the time.

I think that's where the miscommunication lies. I'm working on the premise that there is considerable risk WITHOUT going into a combat zone. Of course, you stage for PD and wait until they clear you, but even then it's not 100% safe...you can't have that mindset or expectation.

I've been on scenes where we're clear to enter, we walk up to victim, and see cops wrestling on pavement just feet from us with suspects. Do you tell the 12 year old with chest the chest wound you'll be right back? Even if you do, point proven that you can't expect the scene to be 100% safe.

Another example, I've worked with a guy who was holding c-spine as a trainee on a shooting, PD on-scene, "scene safe, clear to enter" and original shooter comes back and discharges his handgun into patient's head, next to the EMT's head.

The list goes on.

Then there's the scenes where you don't know there's stuff going on. We had one call with a very unalarming "call type", I think it was a "bleed." That's usually reserved for medical, non-trauma bleeds... it's just me and my partner and we realize a domestic violence incident had just occurred...the deadliest type of calls for cops.

And list goes on...patients that attack you, ambulances that crash, cars that drive into accident scenes.

Not that every area is this dangerous or that you NEED to wear one, but someone working in an area where body armor need is justified, doesn't mean he's trying to be a hero or taking unacceptable risks. Technically, the risk of a car accident is higher, so he shouldn't be taking that risk, either.

[captainstandup]

I agree with anthonym83 in that danger in EMS is often unpredictable. There was a Spartanburg SC Paramedic shot in the face a few years ago by a psychotic woman with absolutely no warning or indication of threat. I think in addition to protective equipment we simply must add tactics and self preservation to the education provided to new folks.

Simply realizing that we should never permit a patient to move to a position where they are out of sight of the crew. We must remain within a proximity that will permit us to take action. In the South Carolina case the patient simply opened a drawer withdrew a weapon and shot the medic. Had he remained within arms reach perhaps he could have disarmed the patient or at least turned the gun on her.

As Paramedics we are often deluded into the "good guy role" and become complacent to the fact that a person may present a real threat to our life. We simply must be prepared to defend ourselves by whatever means possible.

The first step is obviously to plan tactically. Never allow the patient or bystanders to block your path of egress. Always be prepared to abandon equipment and retreat to the vehicle, thats why we have insurance on that stuff. Leave the scene immediately if it becomes unsafe and don't be concerned about issues of abandonment. Your safety and right to a safe work place trumps the patient / provider relationship ALWAYS.

Carry and be prepared to use whatever means of self defense permitted by law. In most states providers are limited to knives and these aren't considered defensive weapons, but instead are tools. Understanding human anatomy is a great advantage in a defensive situation. Just remember, taking away the assailants ability to breathe is a powerful defensive maneuver. Whether in the form of tracheal occlusion or pneumothorax, an airway problem will usually cause a serious loss of interest in harming you on behalf of the perpetrator.

[AnthonyM83]

Understanding human anatomy is a great advantage in a defensive situation. Just remember, taking away the assailants ability to breathe is a powerful defensive maneuver. Whether in the form of tracheal occlusion or pneumothorax, an airway problem will usually cause a serious loss of interest in harming you on behalf of the perpetrator.

Great point there. One should also think about which kinds of penetrating wounds cause most damage...simples clean lacerations or ones that did some exploring and twisting. Also, which are the hollow and solid organs...

It's also important to be able to realize when the situation has gone south and you need to retreat. As medics there might be the tendency to wait until it's too late because of abandonment or compassion issues where you'd like to restrain the person and before you know it, it's no longer a psych trying to escape, it's a psych actively attacking and winning.

I think I'll once again post the http://www.dt4ems.com site Defensive Tactics for EMS