unknown domestic

[knxemt1983]

so we got dispatched a few nights ago to a residence in a not so good neighborhood for SOB. we arrive on-scene just behind the fire engine, and there are there men standing in the driveway as the firefighters begin to make their way up to the house. as they entered the driveway, they dropped their equipment and took up defensive stances. I immediately recognized that this was some sort of domestic dispute that we were entering, so I grabbed the radio and called for law enforcement code 3. We came our to the firefighters side, and got the people seperated. (thankfully the other guys were trained in domestic dispute resolution and my partner is a veteran officer). they kept the angry man, who was ETOH outside while I went to assess my pt. we got the pt loaded on the stretcher and she asked me to go back in and get her purse, and I needed her meds, that the grandson was gathering for me. Well while I was in the house the firefighters and my partner took the pt to the ambulance. The man then decided now was his chance to start a fight, and came in the house blocking my only exit, and no amount of talking him down worked. He threatening to "whip my ***". I managed to get by him and to the door, when he grabbed my arm and threw me into the door, and came at me to I guess "whip my ***". I hot-stepped it off the porch with him in pursuit, but once he got to the driveway he saw my partner and a firefighter, both of who are large guys, and not in a blubbery kind of way, and decided to go back in the house. There were two young kids in the house, so I wasn't comfortable leaving them there, so they got in the truck with me, and I locked the doors up. Law enforcement got on scene and took the guy into custody and sent the kids with the pt's sister. He got charged with simple assault, which is now magnified to felony aggravated assault for interfereing with a Paramedic in the line of duty, violation of probation, and PI. We later found out that he is on probation for a previous assault on a firefighter in the line of duty.

normally I wouldn't have pressed charges, but the fact that the kids live there, and he has a history of abuse of his wife (the patient) and his previous assault of a firefighter, I did. Our system also has now had three insidents of on-duty assaults within a week, and by assault I don;t mean the usual fighting patients, someone tried to carjack one of our brush trucks earlier in the week, it's just getting out of hand.

would you have pressed charges?


just goes to show you we never know for sure what we're walking into, and we never know what people are gonna do. We got away safe and sound, it could've been worse, the police found weapons all over the house.
ALWAYS KEEP YOUR EYES OPEN, AND ALWAYS WATCH YOUR PARTNERS BACK.

 

[Hastings]

Two very important things.

1. It's DIB these days, not SOB. Although that's what the man you describe seems to be.

2. What are you thinking? You had me right by your side up until you decided to enter a dangerous situation after calling for the police. What were you thinking? NEVER enter a home of a known or suspected aggressive person under any circumstances until the police arrive. I'm sorry, that was a stupid thing to do. Stupid, stupid. It's rule #1 of EMS. Scene safety. Sometimes things happen out of your control and you're in a dangerous situation. In this case, your bad judgment was the cause. Bad, bad judgment. Please don't knowingly put yourself in danger again. Wait for the authorities.

 

[KEVD18]

if i was involved in the situation as you described, yes id file against him.

that being said, i would be in that situation."I immediately recognized that this was some sort of domestic dispute that we were entering, so I grabbed the radio and called for law enforcement code 3." this is where the wheels fell off. me, i turn and make a bee line for the rig. at the very least, rollem up and lock em and if its necessary drive away and wait for the all clear from the canaries. i dont know how anybody could realize that they are in a scenario that needs guys with guns and body armor, but is safe for themselves(unarmed and unarmored).

do you know why every scenario in emt/medic school starts with "scene safety"? because me going home unharmed at the end of my shift is the most important thing on any call.

 

[Robby1974]

Agree agree and agree

While on scene it's easy to forget that ONE little first step (scene safetyB))and just think about getting the patient the care they need. So yeah...next time I'd be watin on Metro before I went in. Of course, I'm a little tiny guy 135 pounds wet so I prolly woulda stayed in the rig in the first place till the scene was safe. FUN STUFF!

 

[Sasha]

You had no buisness interferering at all with their domestic disputes!! You are EMS, not LEOs! Obviously you and the fire fighters need a refresher EMT course because you have forgotten the most important rule that is drilled into everyones heads all through out EMT and Medic school. SCENE SAFETY!!

Your number one priority is your own safety, then that of your crew, then your patient. You cant save anyone if you are dead. So he only knocked you around, but next time there could be a firearm somewhere near by, and Im sorry but it doesnt matter how big the rest of your crew is they will not intimidate someone holding a fire arm, nor will they be able to stop a bullet for you.

You have one very important commitment to yourself and your crew every single day, and that is to make sure everyone makes it home okay.

I worry for your safety, not only did you intercept on a domestic disturbance but you went back in ALONE. That is asking to get killed dead.

Press charges, but go read up on scene safety and get your mind right.

 

[Ridryder911]

Although I definitely agree with the scene safety comments, I as well realize it is easy be involved before one can even get back to their unit.

I would had pressed charges with the continuing history of abuse and record against a F/F. Sorry enabling him is not going to help. Sure, one worries about the kids, but are you really benefiting them? If he will strike a public servant, do you not think he will not abuse the kids? ...

If possible press charges, if it gets the kids out.. so be it. You did not cause the situation, it is much better for the kids to be in a different setting than injured or worse, dead.

R/r 911

 

[VentMedic]

For as the OP, double whatever Rid wrote.


Sidenote:

1. It's DIB these days, not SOB. Although that's what the man you describe seems to be.

I can also tell you about one of the very stupid stories from several years ago as to why that was changed in EMS which had to do more with immaturity rather than medical descriptive terms.

That abbreviation is only for some EMS agencies and a few hospitals. It is more accepted in some regional areas than others and not used at all in many. However, if the medical coding offices don't recognize it, it can get labeled as unknown rather than respiratory specific. This can affect reimbursement and limit medical research on various calls.

The acronym DIB for difficulty in breathing appeared in 2,679 chief complaints from New York City but only twice in the >3.5 million chief complaints recorded elsewhere. Such differences highlight the need for more systematic, preferably automated, methods for managing site customization.

http://www.cdc.gov/mmwr/preview/mmwrhtml/su5301a20.htm

One notable difference was that a complaint of dib was recognized by the DOHMH algorithm as an abbreviation for difficulty in breathing and subsequently coded as Respiratory. In contrast, CoCo coded all 106 complaints of dib as Unknown. In fact, dib represented the largest proportion of the symptoms coded as Unknown by CoCo.

http://www.cdc.gov/mmwr/preview/mmwrhtml/su5301a21.htm

So before advising someone to change their abbreviations, check to see what their medical system recognizes and that includes the whole system. There should be some standards in that area for the ambulances, hospitals and insurances. Or, the hospital just translates the patient complaint into what is accepted in their system to be compliant with their standards. Hence, that is a reason why trying to read EMS reports or compare with the ED reports don't always make much sense for hospital professionals and some things can get lost in the translation.

In my area, the EMS services are very mixed on their abbreviations. The hospitals all use a standardized set of recognized abbreviations to reduce medical errors and expedite the coding system. DIB is not an abbreviation in my hospital anywhere and that includes the ED, Respiratory Therapy or Pulmonary uses in the charting, coding or medical research literature.

SOB - Shortness of Breath is still is standard abbreviation in other medical professions and hospital as well as some EMS agencies. So you blanket statement does not hold true everywhere and for everyone.

 

[Ridryder911]

Two very important things.

1. It's DIB these days, not SOB. Although that's what the man you describe seems to be.

Thanks Vent did not know what that stood for. In my thirty plus years, never seen or heard of the abbreviation. We continue to use SOB or ShOB for the ER board, that the public can see..

R/r 911

 

[FFMedic1911]

Agree with Rid you can be in it before you know it.Always remember scene safety.Also charge the :censored::censored::censored::censored::censored::censored::censored: he needs in jail.

 

[KEVD18]

in some cases you can certainly be in the thick of it before you know the excrement has hit the ventilation device.

but in this case, all four responders were still exterior to the house when the "DANGER" alarms went off. plenty of time to turn and burn.

never heard dib either. yet another example of why blanket generalizations are not good.

 

[mikie]

I'll echo what everyone else has said...SCENE SAFETY.

Wait for LEO to take control of the scene. Once under control and the scene is SAFE, do your thing.

I would 'whip' his ***, defensively of course

I hate to put it this way, but you learned your lesson on this call and hope you don't have a repeat.

You are fortuante to have had FD there for more manpower. If it was just you and your partner entering the house, who knows what would've happened.



So from now on and forever...stay safe.

 

[Hastings]

They're teaching DIB over SOB in all medic schools I'm familiar with for the reason that you probably have a story about. Clear and simple, too many misunderstandings with those unfamiliar with what SOB actually stood for.

 

[KEVD18]

never heard it. spoke to a few friends in the business today and they ahve never heard it. and we didnt learn it in medic school either.

 

[Hastings]

never heard it. spoke to a few friends in the business today and they ahve never heard it. and we didnt learn it in medic school either.

How long ago did you go to medic school? I think this is a pretty newish thing. We're talking about medics of the last two years being taught this new term.

 

[mycrofft]

No long rant from me.

One of the owners of my second civilian ambulance company was doing a weekend as a reserve deputy and shot dead as he opened the door onto a domestic. The "unknown domestic/shots fired" my partner and I went on yielded a 12 y/o with an eighth of his head blown off and assailant unknown as we arrived. No one was served by rushing in.

'Nuff said, live to post another day.

PS: Charge the bahstid. Send him to me.

 

[VentMedic]

How long ago did you go to medic school? I think this is a pretty newish thing. We're talking about medics of the last two years being taught this new term.

They're teaching DIB over SOB in all medic schools I'm familiar with for the reason that you probably have a story about. Clear and simple, too many misunderstandings with those unfamiliar with what SOB actually stood for.

No. They are not teaching this in ALL of the medic schools. How can you make such a blanket statement? There are 50 paramedic programs just in Florida. There are also several of us on this forum who teach in Paramedic programs.

Quite possibly if EMT and Paramedic programs were to have a medical terminology class as a prerequisite there would not be such confusion.

Did you bother to read the CDC statements I posted earlier?

Yes, some EMS people giggle when they say SOB but that doesn't make it less accepted as a medical abbreviation for medical professionals who know medical terminology and abbreviations.

 

[Hastings]

No. They are not teaching this in ALL of the medic schools. How can you make such a blanket statement?

"all medic schools I'm familiar with" - That's how. Not so blanket under those circumstances.

Quite possibly if EMT and Paramedic programs were to have a medical terminology class as a prerequisite there would not be such confusion.

Taught DIB in my Medical Terminology class, taken prior to medic school, as well as the EMT school following. And then, into medic school. DIB was also the official terminology on all my ride-alongs and clinicals. It has been fully adopted in Michigan. And as such, all medic schools I'm familiar with use DIB over SOB.

 

[traumateam1]

Side Note:

We still use SOB, or ShOB here. I wasn't too sure what DIB was until someone explained it.. so I guess I'll see if it changes here in the next little bit.

 

[Ridryder911]

"all medic schools I'm familiar with" - That's how. Not so blanket under those circumstances.



Taught DIB in my Medical Terminology class, taken prior to medic school, as well as the EMT school following. And then, into medic school. DIB was also the official terminology on all my ride-alongs and clinicals. It has been fully adopted in Michigan. And as such, all medic schools I'm familiar with use DIB over SOB.

Well it appears it is only a local thing. Your the only member here that appears to use it. As mentioned very few has even heard of such. I teach and lecture nationally, I too as well have never heard of such.

 

[VentMedic]

"all medic schools I'm familiar with" - That's how. Not so blanket under those circumstances.



Taught DIB in my Medical Terminology class, taken prior to medic school, as well as the EMT school following. And then, into medic school. DIB was also the official terminology on all my ride-alongs and clinicals. It has been fully adopted in Michigan. And as such, all medic schools I'm familiar with use DIB over SOB.

We have 50+ different EMS certifications that goes opposite of every other health care profession that has established standards. Now different states are having their EMS go opposite from other medical stanards by establishing their own abbreviations?

I have yet to see DIB used in medical literature and I read alot of respiratory journals. I even read the rag JEMS for chuckles.