Should EMS/Fire Personnel Be Armed?
The topic of “Should EMS/Fire be armed” has been around as long as I have been teaching DT4EMS/EVE (and probably longer). The question will also have to take into account the feeling of the “average” provider about having to carry a firearm on duty and the responsibility that comes along with it.
First thing is for me to make a statement; The overwhelming majority of assaults on EMS/Fire are not life-threatening, they are all however, life changing. This topic is not a “gun” issue. It is a training issue. Take a look at my Armed EMS and the Surgical Cric post and to Arm or Not to Arm.
If the only major media reporting is the potentially lethal encounters of EMS/Fire due to violence, then the perception is potetnailly fatal violent encounters are all that exist.
On the Issue of Arming EMS from Kip Teitsort on Vimeo.
Skip Kirkwood and I took on this issue back in August of 2012. Here is a link to the article in EMSWorld. LINK TO EMSWORLD
To date, I have been interviewed by several media outlets on the subject of violence in EMS/Fire including TV, radio and newspapers in Missouri, Arkansas and Ohio. With the limited time for on-air-editing, I want to make sure my position is perfectly clear. I am not anti-arming EMS/Fire. I am stating there must be a culture change. There is a serious lack of training for violence prevention/recognition and escape that we in EMS/Fire we face. Then since the media only really covers the major violent incidents where providers are seriously injured or killed, the average provider believes the only assaults that occur are lethal in nature.
The provider, if allowed to carry a firearm must, be trained with all of the tools and where each is applied within the use-of-force continuum.
Here are a few of the links.
Link 1-KY3
Link2 Dayton
Link3 Radio
Here are some actual numbers of assaults in emergency medicine. Mind you, I still believe there is an under-reporting of true criminal assault. According to the NAEMT’s study released in 2005, 52% of providers had been assaulted on the job. A 2008 study from the Emergency Nurses Association found that more than ½ of emergency nurses experienced violence on the job. Dr. Brian Maguire’s study found the EMS provider is 22 times more likely to be assaulted on the job than any other private sector industry.
The big picture is violence. Not all violence faced by EMS/Fire are lethal encounters mind you, but violence is the issue. Simply allowing someone with only a conceal carry weapon permit (CCW) to carry on the job is not only dangerous, it has potential liability concerns. Remember the statement “ Well, if your only tool is a hammer, then every problem will look like a nail” ?If the only tool given to the provider is the firearm, without all of the training and other tools that leads up to the potential use of lethal-force, the gun becomes the proverbial hammer.
I will remove my reservations for arming EMS with a firearm when training concerns are met.
Here are a few of the main issues:
Force Options– There must be training for each level of a potentially violent encounter. The provider must have options other than nothing and the use of a firearm. If there is enough danger to arm with a firearm, then EMS/Fire should receive all of the Verbal Skills, Empty-Hand, OC/Pepper Spray and Baton training as well.
Weapon Retention– Must have training on what to do in a grappling/close quarter situation.
Here is a link to an FBI study and the numbers of officers killed with their own weapon. It at least must be considered that if the provider shows up on a scene with a firearm, if there was no gun present before the provider arrived, there is one now. (LINK FBI)
A police officer has a focus of custody/control on every scene. EMS/Fire focus is to provide “care” under “consent”. So the focus on use-of-force training must be different, but similar in when it comes to legal issues and the mental preparation for the use of force, lethal or not.
Police show up to take custody/control in the form of an arrest. So training started in an academy with officers learning the “Law” and all of the book-stuff if you will, in the academy. Then it moves to training on verbal skills and how to employ them in different situations. Then an officer receives training on empty hand skills on how to “control” a person and take them into custody and what to do when the suspect is resisting an arrest.
If the empty hand fails, the officer moves up a trained continuum or the ladder/steps to intermediate tools like pepper spray/Taser and possibly the use of a baton/stick. Each section building upon the other to give the officer force options. Now during the academy the officer has range time (usually a minimum of 40 hours) learning to not only shoot, but to train to shoot from cover. Along with the firearms training comes the training of in-hand and in-holster weapon retention and weapon disarming for if weapon retention skills failed. It is only If the officer reasonably fears for his/her life or the life of someone else does he/she resort to the threat or use of lethal force. It is the hours of training that help the officer make a REASONABLE decision. With the lack of force option training for escape, my fear is the standard talk of the station (Whack-em with an O2 bottle, or the Maglite to the head mentality will still exist).
So when we look at what it takes for the average officer who go into unknown situations must have to carry a gun on the job (similar scenes/situations EMS/Fire respond to) why should the standard of training be only 8 hours to allow EMS to carry on the job? It takes more than just 8 hours to have both mental and physical and preparation for the use of a firearm ON-THE-JOB. But for Christ sake, give the provider the other options as well!!!
I am a strong supporter for citizens to have the right to bear arms. But due to the dynamics involved with carrying a firearm into unknown scenes/situations requires much more training than that of an 8 hour CCW course. My concern remains the same as it always has; Violence in healthcare is an issue. Providers MUST be trained to recognize potential, avoid if possible and defend if needed the violence we KNOW exists on the job. We must train for the probable, not just the possible. With 52% experiencing physical violence on the job, that is a “probable”, not just a possible. But remember the overwhelming number of violent incidents in the pre-hospital or ED setting can be avoided or mitigated without the threat of lethal force.
There is another thing to think about; the ambush type situation. If you refer back to the FBI study, several officers were killed in ambush style attacks. They (officers) have training, vests, multiple tool options but were attacked by surprise and murdered. The ambush style attack is very difficult, if not nearly impossible to defend against. A handgun in ambush situations would have limited effect against the murderer shooting a rifle from a distance. We train in every class to look for cover and concealment upon the arrival on ALL calls:
Questions I also pose, Will arming EMS/Fire have them respond to, enter upon or remain on a dangerous scene that they otherwise would not? I don’t know the answer but the question bears asking nonetheless.
For years, many front line staff has made comments about wanting to carry a firearm on duty. Some already do, simply without permission. Again, I am not anti-arming EMS/Fire. I am stating there must be a fundamental culture change. There is a serious lack of training for violence recognition, prevention and escape in EMS/Fire we face. The firearm, if allowed, must be trained where it needs to fall within the use-of-force continuum. Which means, most assaults are not life-threatening, they are all however, life changing. We must change the culture in EMS/Fire and spend the majority of time training for the probable (less-than-lethal attack) not just the possible (lethal encounters).
The firearm can’t be the only anti-violence tool/option the provider is given. It is a known fact EMS/Fire and ED staff face violence on the job. Equip staff with the tools/training they need to go home safe at the end of a shift. A firearm may end up being one of those tools but without all of the training that goes into allowing the carry of a firearm on the job, it is my opinion, the provider and the agency will face more liability.So in closing, I am opposed to the arming of EMS/Fire (on-duty) until all of the training issues are addressed. If those training issues are part of initial and on-going training then I remove all reservations. I mean come on….. you have to take CPR every two years and Blood-Borne Pathogens annually…yet little to no training for the violence encountered. It’s a training issue, that will lead to a culture change.