How Safe Are You?

Stabbing, must be a Tuesday. Oh another domestic with a baseball bat? Thursday. I’ve gotten accustomed to violent calls. My partners have gotten accustomed to my head being on a swivel. Don’t get me wrong, I pay attention to the patient and treat them, I’m just always paying attention to my surroundings as well. Twice in the last 3 weeks I walked into a room to find an agitated patient in pain with a knife in arms reach. They weren’t threatening anyone, but there’s something about a 8 inch dagger or a 10 inch kitchen knife stabbed in the wall that puts you on edge.

Color me cautious and I wouldn’t argue. Remember Mark Davis, he was shot and killed with a hunting rifle while on a call. How about the RN that was stabbed while tending to a college kid who had taken mushrooms? That call happened about 45-60 minutes north of us. Not exactly downtown LA. He was transported to the ER for a psych evaluation, then stabbed the nurse. Think about that, he was armed and in the ambulance with the EMT’s but waited until he arrived to the ER before pulling the knife out. He could have easily decided to stab the crew instead. Do you know if your patient is armed? Well I know what your saying, now the police search them before they turn them over to us right? Not to upset the police but honestly the answer is sometimes they do, sometimes they don’t. It depends on the agency and the officer.

I can recall two patients being brought to local emergency rooms by police, one was found to have a kitchen knife and the other a pistol. Both were found by ER staff during exams, both had been ‘searched’ by the police, luckily neither person decided to use them prior to their discovery. By the way one was a state police agency, the other was local. The guy with the 11 inch knife said he kept quiet about it because he didn’t want to embarrass the cop after it was missed during the pat down. It was tucked into his waistband, not exactly smuggled in. We’re at fault to, have you ever searched your patient? I’m not saying the 80 year old woman from the nursing home, though there I have heard of 70 year old patients wielding knives. It’s not hard to lift a shirt and look at the waist band, lift the pant legs to look at the socks. Sometimes I just ask the patient if they have a weapon. Be polite and use the words “anything that could hurt either one of us” and you might just have them say yes.

So here we are, maybe you’ve been there, maybe you haven’t. Dispatch squawks out a call, ”Scaredy Fish respond to a 123 Main Street for a female assault no further information. PD is enroute.” We respond and upon getting 2 blocks away call dispatch and ask if we should stage away or if PD reports it is safe to continue in. Their response, “Fire first response is on scene and went inside, PD hasn’t arrived yet.” OK, no patient update, Fire isn’t reporting it’s safe or unsafe, and you only know that they arrived on scene then went in the house? That doesn’t answer my question then does it? Did fire respond and find out that it was a couple of drunk college kids who were fighting over the last shot of Jagermeister or did they walk in and the last thing they saw before being shot was the unconscious victim on the ground? This is actually more common than you would expect. I still remember being dispatched to general illness at a house that had no power, at 3 am and standing on the porch with the door left open for us. Pitch black and a voice yelling “come in he’s over here!” Uh…No.

The problem is all in the point of view. Think about it, if a Chihuahua bites you on the hand, you might not get too worked up, even if you need a couple stitches. If a German Shepard or Pit Bull causes the same damage as the little dog, it becomes a DANGEROUS NEAR DEATH DOG ATTACK! The news covers it, you tell of how you nearly died from blood loss and your sheer grit and love of your country pulled you through. We live on war stories, trading battle tales between veterans. The drunk that took that swing at us, he got me good but I got him better right? I got this injury/scar when…remember the time…fill in the blank. Why is it that we don’t worry about it until it’s a drunk that pulled a gun. No better to wait until something bad happens. It’s just terrible, another Line of Duty, glad it wasn’t me. Where DID I put that black banner and my funeral shoes?

I wish there was something I could have done. Well do it! NOW! Pay attention and look around. Run things through your head. It’s time to listen to that little voice, no not the one telling you that parachute pants are going to come back in style. Listen to the one that says HEY, how about we don’t go running after the psychiatric patient who just disappeared into the back alley. Maybe I should knock on doors standing to the side, not in front of them. Do I have a clear exit from the scene? Scene Safety, BSI, remeber that? Time to brush off that old EMT book and reread a section or two. Learn about the neighbor hood your working in or the district. Where are the trouble sections? Is there a gang presence? Learn about them, their colors, graffiti, signs and enemies. I’ll have a post about gangs that later but trust me, despite the nay sayers, it’s worth reading about. Remember just because your paranoid, doesn’t mean they aren’t out to get you, right? Seriously, I personally would much rather look back in 20 years and think that I was a bit overzealous than have my family and friends look over my hospital bed or coffin and wish I had been more cautious. I think my mother agrees with me too.

Stay safe and alert
~SF