It is time to arm EMS/Fire with knowledge of the use-of-force on the job.
Before we get too deep, riddle me this… Why do so many front line staff wish to carry a gun on duty, yet many administrators do not feel (on-the-job) self-defense training is important? Where is the disconnect?
I will preface this rambling… I am not “anti-arming” anyone.
I am stating without all of the use-of-force training that goes along with carrying a firearm into unknown scenes/situations…would be like having only the surgical cric as the airway tool for all respiratory and airway problems.
Stay with me here.
Folks it is much more than just an 8 hour CCW class. As a subject matter expert regarding the use-of-force within the medical community, I simply want to approach this from the training perspective, since that is what I am known for. For an administrative perspective, Skip Kirkwood and I did some work here for the EMSWorld article and from a legal perspective, well known EMS attorney David Givot did a fantastic piece here. You can also refer to this post where a police officer/EMT and firearms instructor also addresses the issue on arming EMS/Fire.
In my 17 years as a police officer, I never had to shoot anyone. I am happy and proud of that. I had a firearm accessible, but I had other tools and training present as well, because not every time I took a person into custody was it actually a potentially lethal scenario. This training allowed me to choose amongst lower levels such as verbal skills, empty hand skills, Pepper Spray, and a taser on many occasions (I only had to warn the potential use of my baton a few times to effect an arrest….but it was an option).
Only two times in my career did I ever actually think I may have to take another person’s life. The main one that sticks out in my mind was when I was surprised by a suspect holding a machete raised above his head less than 3 feet from me-I had responded to a report of a violent domestic disturbance. I have also had an ambulance car-jacked while loaded with a patient and used force to defend myself. So, I speak from experience as a medic AND a police officer regarding the use of force on the job.
Not to mention history has shown (CLICK LINK), with a lack of training, some providers have assaulted patients and bystanders under stress.
You can also see how many in medicine already perceive the use-of-force here: JADED
I have given many analogies regarding my concerns of armed EMS/Fire folks without all of the training that goes along with such a thing. If a person armed with a concealed weapon does not have training for all of the other violent encounter possibilities will they threaten every person who grabs, pushes, or verbally threatens them? I am not saying they will, but it is obviously a probability- just read about how many state they would respond to any violent encounter on social media sites.
They are full of “I’d choke ’em out”, “I’d whack ’em with an O2 Bottle” etc. with no concept of leaving (as an option) first, or the recognition of a patient is actually different from an attacker. And remember a conceal permit allows a person to “carry” however; it does NOT authorize “use”.
I need you to think about it like this, the average paramedic is trained in how to perform a surgical cric. THe medic is trained to understand the cric is reserved for the direst of situations where the medic had no other choice but to resort to it, a last ditch effort so to speak. However, the medic is trained in numerous other less invasive (dangerous) skills as options, prior to resorting to the use of the scalpel.
This airway progression would start with airway and breathing assessment, and then the choice of moving from something as simple as positioning to a nasal cannula and progressing through possible choices/steps to a NRB, OPA, NPA, Assisted Ventilations with a BVM, then the choice of an LMA equivalent and moving into the need to intubate the trachea. It isn’t until there was no other choice does the medic resort to the use of a surgical cric. Here with the regards to training, the cric is similar to the gun. So why is the mention of training for all of the things (force options) that lead up to the most difficult/dangerous choice (gun) met with such passion? In medicine we already agree BLS before ALS, simple airway before advanced and “try before you pry” for extrication, but let’s not dare think we need to do anything (training) before carrying a gun on-duty. That simple suggestion will spark outrage…
There must always be a progression in use-of-force training just as there is in emergency airway skills. In the airway and breathing we start simple with actually recognizing if the patient has a patent airway and is breathing ok. If not, we would progress to whatever step/skill needed as previously mentioned to manage the airway and breathing. The same with a use-of-force training standard; there is a recognition of patterns/problems in body languages- the recognition then would have the provider create space. If it was verbal aggression the provider would respond with professional verbal skills. In the incidents of low-level physical aggression like a wrist/shirt or arm grab the provider would use a low-level escape move.
Isn’t it possible a confused nursing home patient could grab a provider in a similar manner as a drunk/drugged individual yet the nursing home patient have no intent to harm? There is a ton of discussion about “critical thinkers” in medicine right? How does a person progress through choices if they were never given the options via training?
One technique/tactic or tool can’t be trained for use in emergency medicine “across the board”. Our environment is unique. Critical thinking must come into play with regards to the use of force in self-defense or application of restraints. In order for that to happen, training must take place.
I first used the analogy across the internet…. “If your only tool is a hammer, every problem will look like a nail.” Meaning there is a lot of training that should be required prior to an agency permitting armed staff. If the choice is limited to either NOTHING and LETHAL force well, let the legal and media frenzy occurs. You can draw a parallel to the case in Florida where a person having a conceal carry permit, uses a “stand your ground law” and shoots/kills an unarmed alleged attacker and claims self-defense. Although not arrested initially, is now currently in the battle of his life both legally and in the court of public opinion. Regardless of where you stand on that case, you see my point.
There is a widely known case law in law enforcement as it relates to training. It is commonly referred to as the “Failure to Train” case known as Walker vs. New York. I am not an attorney, but as a law enforcement defensive tactics instructor, I had to become familiar with it. The reason was simple; a police officer had to be trained with the tools he/she carried in order to help them make appropriate decisions with the use of that tool. This way if the agency and officer were sued over the use of force, the officer could not say “well nobody told me I could (or couldn’t do) such and such”.
Arming a provider without all of the use-of-force/force level training that goes with it……is simply like teaching people to perform ACLS without them ever knowing CPR, it just won’t end well.
All I am asking is people really research the use-of-force issues. Understand how a person processes information under stress; look at training for the probabilities not just possibilities. Every officer is trained in the academy for weapon retention and some form of weapon disarming for if their weapon retention skills fail and then they are told….. “If you show up on scene, and there wasn’t a firearm present before you got there, well….there is now at least one [firearm] on scene.”
Just make your choice an educated one. Regardless, I have been screaming/preaching this message about scene safety and the dangers we face since 1997……so I am on your side. My passion has been to keep providers safe on the job. Sometimes, it is keeping them safe from themselves.
So, again, I am not “anti-arming” anyone. I am saying there is a lot of training that should be in place before a person decides to carry on duty and an agency permits it. Think of the gun like the surgical cric. It is that last ditch effort to save a life but there are other choices and things we should have been at least able to consider prior to going straight to it.
