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Mean Urban EMS

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Tuesday morning, Los Angeles firefighter/paramedic Charles Anthony MacDougal received multiple stab wounds while treating a patient in front of a hotel in the area formally known as “Skid Row.” LATimes article HERE. Blogdowntown article HERE.

MacDougal has nine years on the job and works out of Fire Station 9. Before the stabbing MacDougal was to receive “Paramedic of the Year” award from County-USC hospital, where he was treated for his injuries. (LAist article HERE)

Urban EMS has always been tough, with a higher percentage of assaults and attacks on ems providers than in the suburbs.

JUST READ THE CHAPTERS

Street sense, defined as situation awareness and personal survival skills, is not one of the main topics in the National Curricula or a National Registry test station.

I used to teach the “Operations” block in the paramedic curriculum. Covered ambulance operations, (heavy) rescue awareness, incident management, hazardous materials and crime scene etiquette in four to six class contact hours.

It was at the end of the paramedic program, when both students and lead instructors are suffering from “senioritis.”

I did my best by using local information, student role playing (MCI tabletop) and vivid case studies, like the 2003 Epitome2 stampede in Chicago (21 dead, 65 seriously injured).

LITTLE MEASURABLE CHANGE IN BEHAVIOR

But the four module, 130 slide, three video presentation with hands-on activity was, at best, entertaining.

For the firefighter with two or more years on the job, it was a review with a strong EMS twist. For the 19 year old, it was trivia to regurgitate for an exam. The inexperienced has no reference or incidents that hold a deep personal importance.

Should ems providers get the same street survival skills our law enforcement colleagues receive?

Mike “FossilMedic” Ward

Also on FireGeezer…

Posted by on May 19, 2010 • Filed under: EMS Topics, Training & Development, Urban Commander • Tagged: , , , , , , ,
  • B.Morgan

    I think that all EMS responders need some sort of street survial skills. Not to the point of carrying firearms but being both caring and careful. I worked a lot in rual and wilderness areas and had several bad encounters. Cross training in street survival provided me the skills to see that things were going bad and to take protective actions to keep myself and paitent safe.
    Several times I was attacked by patients, usually drunk or on drugs. My usual reaction to a threat from a patient was to get the hell out of there untill police arrived.

    Good teamwork and situational awareness are keys to the EMS providers safety.

    Assume nothing and expect anything.

  • http://618rants.blogspot.com Mr618

    B. Morgan has hit the nail on the head, with one caveat. In most areas, it probably would be sufficient to provide situational awareness training, as Morgan suggests. Unfortunately, though, in certain areas — NYC, DC, and LA, for instance — it may be necessary to provide the same “Street Survival” training the cops get. There are some places where a person in uniform — ANY unform — is considered fair game for the bad guys. Firefighters and EMS staff aren't paid enough as it is (and neither are the cops, for that matter); it is (or should be) a moral imperative to enable them to go home safe and sound at the end of a shift. And if that interferes with some jerk's 'right' to be a violent ass, well, that's just too damn bad.

  • medic5

    I'd say yes. Things fell apart with interagency protocols leading to me never actually working on a tactical team but I still believe that the time I spent at the International School of Tactical Medicine is among the best training I have ever had. Learning how to function durring and anticipate threats is a skill set that is becoming more and more important in EMS.

  • Paul C

    In my experience, the training of EMS providers focuses patient assessment and not scene management. I was taught to start assessing the patient as I walked in the room. I was not taught how to assess the scene. As the level of violence in general increases and the fact that many EMS providers look like officers except for the patch I think that street survival needs to be taught to all public safety personnel, not just law enforcement.
    Maybe you could work this into the EHS program at GW, just pick a classs I have already completed. I'm getting to old to get physical

  • http://www.firegeezer.com Mike "FossilMedic" Ward

    Reply from the facebook posting that is interesting:

    Tim Robinson There are defense tactics skills that I learned in training as police officer that I have had to execute working on EMS calls. 1 of them, disarming someone of knife, I have never used in law enforcement but I had to use it on a medical aid call. I think some defense tactics should be taught as a part of EMS training in safety and survival.

  • http://www.firegeezer.com Mike "FossilMedic" Ward

    Paul C:

    Pretty hard to practice a take down or rendering a weapon safe through an online class :)

    Mike

  • http://618rants.blogspot.com Mr618

    B. Morgan has hit the nail on the head, with one caveat. In most areas, it probably would be sufficient to provide situational awareness training, as Morgan suggests. Unfortunately, though, in certain areas — NYC, DC, and LA, for instance — it may be necessary to provide the same “Street Survival” training the cops get. There are some places where a person in uniform — ANY unform — is considered fair game for the bad guys. Firefighters and EMS staff aren't paid enough as it is (and neither are the cops, for that matter); it is (or should be) a moral imperative to enable them to go home safe and sound at the end of a shift. And if that interferes with some jerk's 'right' to be a violent ass, well, that's just too damn bad.

  • medic5

    I'd say yes. Things fell apart with interagency protocols leading to me never actually working on a tactical team but I still believe that the time I spent at the International School of Tactical Medicine is among the best training I have ever had. Learning how to function durring and anticipate threats is a skill set that is becoming more and more important in EMS.

  • Paul C

    In my experience, the training of EMS providers focuses patient assessment and not scene management. I was taught to start assessing the patient as I walked in the room. I was not taught how to assess the scene. As the level of violence in general increases and the fact that many EMS providers look like officers except for the patch I think that street survival needs to be taught to all public safety personnel, not just law enforcement.
    Maybe you could work this into the EHS program at GW, just pick a classs I have already completed. I'm getting to old to get physical

  • http://www.firegeezer.com Mike "FossilMedic" Ward

    Reply from the facebook posting that is interesting:

    Tim Robinson There are defense tactics skills that I learned in training as police officer that I have had to execute working on EMS calls. 1 of them, disarming someone of knife, I have never used in law enforcement but I had to use it on a medical aid call. I think some defense tactics should be taught as a part of EMS training in safety and survival.

  • http://www.firegeezer.com Mike "FossilMedic" Ward

    Paul C:

    Pretty hard to practice a take down or rendering a weapon safe through an online class :)

    Mike