15 June 2006

Blue canaries

EMT-I class last night was interesting. A guest speaker provided a whole different type of lecture, compared to Monday's anatomy and physiology, about violent situations, personal safety, abuse, and crime scene awareness. He was a state trooper for 20+ years before becoming a paramedic for the last 10+ and also works as a SWAT medic, so he's got a lot of experience with dangerous situations.

First rule, always send the cops in first if you suspect any unsafe situation. They get paid and trained to handle violent, dangerous people, EMTs do not. And if you're not the person with direct patient care, your job is to watch the bigger picture, including the "bad guy". I'm going to struggle with this assignment on the street because I want to help with whatever is happening with the patient and not just stand there and try and pay attention to everything else. Conceivably I could delegate this task to one of the firefighters who are frequently on scene, but I think this would take some discussion with whomever I was partnered with to figure out how it is going to work and would have to be FD people that you would trust to remember that they are supposed to be watching your back.

Anyway, lots of food for thought with everything from where and how to stand on a call, to how to read body language of potentially aggressive people, to choices for body armour. Also he had some good insights into communicating with the local PD to find out ahead of time what they use for guns, non-lethal weapons, body armour, etc. so you know what kind of injuries they are likely to cause and receive. He gave a couple of good reasons for ambulances to carry a single set of old-style chain handcuffs (it has NOTHING to do with restraining patients - we have restraints for that specific purpose) and at least 1 handcuff key even if you don't have the cuffs themselves, both of which are supplies I would never have remotely thought of on an ambulance.

The abuse section is always hard because it gets you thinking about all the bad things that happen to people. Since I've been involved with a lot of elderly patients lately, seeing and talking about the elder abuse was much more difficult than it has been previously. EMTs are mandatory reporters, so if we see something questionable, it requires a phone call to the appropriate agency or a report to the doc at the ER or both. It is always good to be reminded of that and to remember that I have to stand my ground if something doesn't feel right.

Crime scene awareness always starts off feeling kinda cheesy with repeated entreaties of "don't touch anything", but he was able to give us a couple new things to think about - like at car accidents to be paying attention to any marks left on the road so you don't park the ambulance on them or drive through them, noticing what gear the transmission was in, and making sure not to do things like turning off the headlights or at least remembering to tell the police that you did it.

Any class or lecture is always more enjoyable when it makes you think and gives you immediate practical information, so even though I didn't really want to be there the full 4 hours last night, it was a great lecture to have and well delivered.

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