# Scene Safety Scenario



## DT4EMS (Jan 1, 2009)

What would you do?


It is a warm sunny afternoon you and your partner are just getting ready to sit down and watch some TV at the base, when the tones go off.

You are dispatched to a report of a two-year-old child that is bleeding from the mouth. Dispatch asks you to call in for further information. When you call the familiar dispatcher on the phone, she tells you law enforcement is also en route. When you ask why, she tells you the caller sounded intoxicated.  There are no other indicators of scene safety issues. The dispatched just wanted to “play it safe”.

As you arrive on the scene of a rural house a patrol car is pulling into the driveway ahead of you. The officer makes his way to the house a few feet ahead of you. Nothing seems out of the ordinary.

A scruffy looking man invites you in. He appears to be in his 50’s. He is of a large stature and has an un-kept appearance. He has a thick poorly groomed beard. He reeks of an alcoholic beverage.  The man is cooperative and polite.

He tells you his nephew was jumping on the bed and is now bleeding from the mouth. You can see the child is up and playing. There is a small amount of blood on the child’s shirt. 

Your partner puts on his gloves and without warning the man now yells “What do you need those for…….. You gonna put your finger up my a$$!!?? His tone has gone from cooperative to aggressive. 

The police officer tells the man to “Shut up and let the ambulance guys do their job!” You try to explain to the man it is standard to wear gloves as the officer escorts the man across the room to a chair. The man sits in the chair and you continue your assessment. The man continues to mumble, but stays seated.

You notice the child appears fine. A small laceration on the bottom lip that has stopped bleeding is apparent. 

Now, another man arrives at the residence claiming to be the child’s father. The man stated the other man, the scruffy guy, is actually the child’s uncle who was supposed to watch him while the actual father went to run errands. 

The boys father explains the uncle has a drinking problem and was not drinking when he left a few hours earlier. You explain your physical assessment findings to the father and are obtaining a signature on the AMA Form. You are bottle necked in the foyer of the front door, prepping to leave when without warning you hear ‘You mother fu^*er$!! You look over your shoulder to see then man charging at you from across the room. 

Your partner, the father (holding the child) and the police officer are all blocking your exit. The officer begins to push forward ( from behind you) as others are trying to get out the door. 

Only a couple of nano-seconds pass before you are face to face with a hacked off, intoxicated Grizzly Adams…………………..

What do you do?


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## Shabo (Jan 1, 2009)

This begs a few questions,
1. What other routes are there? I should have had two scoped out when I walked in, but definitly after he got loud. 
2. Where is my cot outside or inside? can I use it as a barrior?
3. How much room do I have to manuever?


My goal is going to be two fold 1. allow the cop to do his job, and 2.ensure my safety. 

The key at this point is space and his intent. Is he going for me, my partner, the cop, or the kid. 

If I can hinder the advance with the cot while not blocking the cop then thats my play. If I don't have the cot can I sidestep (or otherwise) to release the cop? If I can't block the advance or move out of the way then it's time for a defesive stance (boxing) with open palms presented(non agressive) to absorb or redirect if possible.


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## Bosco578 (Jan 1, 2009)

Decide to engage or not. At this point step into him and knock him off balance,enough time for PD to engage.


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## jochi1543 (Jan 1, 2009)

Possible options would be:
1) run
2) throw your voice and use that second to run
3) throw an obstacle in his way (e.g. chair) and run

h34r:


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## Bosco578 (Jan 1, 2009)

jochi1543 said:


> Possible options would be:
> 1) run
> 2) throw your voice and use that second to run
> 3) throw an obstacle in his way (e.g. chair) and run
> ...



I'd kick him in the junk or punch his throat.


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## exodus (Jan 1, 2009)

Yeah, I would probably push him and get away from the scene until PD backup arrives or the uncle is in cuffs.  If the dad were to get into the scuffle, I would also move the kid away so he/she won't get hurt.

You don't mention where the kid is in all of this... Personally, I would protect the kid before myself in this situation since I'm not going to get too injured in a sober vs drunk scuffle. But if the kid were to get hit or knocked over, his body would have a lot more of  hard time recovering than mine.


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## KEVD18 (Jan 1, 2009)

since this question came from kip, im willing to bet that double tapping and redirecting momentum are involved somewhere. i havent the foggiest idea where or when, but ive seen enough of his video clips to pick that much up.

on the other hand, it wouldnt suprise me if the proper answer is "you shouldnt have let yourself be bottlenecked in the first place, you dope"! followed by an abrupt slap upside the back of the head.


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## DT4EMS (Jan 1, 2009)

KEVD18 said:


> since this question came from kip, im willing to bet that double tapping and redirecting momentum are involved somewhere. i havent the foggiest idea where or when, but ive seen enough of his video clips to pick that much up.
> 
> on the other hand, it wouldnt suprise me if the proper answer is "you shouldnt have let yourself be bottlenecked in the first place, you dope"! followed by an abrupt slap upside the back of the head.




Bwahaha! You guys are great!

What I am getting at is mental preparation. Many, many studies have proven training the mind is just as important as the skills you possess.

OK lemme try to answer a couple here:

1) Kid is still in dad's arms in the doorway.

2) Having a heightened awareness when the drunk jerk changes his tone is a great thing.

3) You don't see a back door in this place.

4) Your cot is outside. No need to drag it in. 

5) Remember, the AMA is being signed...... you were on (what you thought) was your way out the door. Others just beat you to the exit.


So, lets' continue.......... We have a few people with physical actions in defense of themselves.

1) What would be the appropriate force level, if any (technique) used?

2) Would you say anything at this time?

3) If you used force or didn't, would this be a situation in where a police report would be filed?

Once we have had folks go through this a few times I will chime in with what actually happened.


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## exodus (Jan 1, 2009)

Well then, I would try to just get him to get by me. I'm obviously stuck in the doorway though, with 2 or 3 people in the way to move out of the way, so when he gets close I would try to grab his arm and push him out of the way or down. And then get out of the way so the PD officer can get at him. 

Only problem I see with this would be potential reprocussions through the company if he gets hurt, but if he's charging at me, is drunk, and is belligerant, he's going down.


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## DT4EMS (Jan 1, 2009)

exodus said:


> Well then, I would try to just get him to get by me. I'm obviously stuck in the doorway though, with 2 or 3 people in the way to move out of the way, so when he gets close I would try to grab his arm and push him out of the way or down. And then get out of the way so the PD officer can get at him.
> 
> Only problem I see with this would be potential reprocussions through the company if he gets hurt, but if he's charging at me, is drunk, and is belligerant, he's going down.



Outstanding!!

The most important part is there is MORE than just the physical portion of an incident. There are a plethora of things that occur after the fact as well.

In this situation, a quick palm heel check to the guys chest created space to get away and allow the officer to make the arrest. Drunk guy was charged with assault. Incident gets documented. Not on the patient care report but a separate incident form.

This is just one of those situations......... a scene were pretty much everything was over, we were getting ready to leave. Even the officer felt the scene was secure that would be the reason fro him being in the doorway as well.There was also no real verbal contact between me and him. No one was even paying any further attention to him because he was sitting across the room.


Trust me we can badger on how to control a scene but the truth is we can never control every aspect of a scene. We can never rest and assume a safe scene will stay safe.

Anytime one of the "5 D's" are involved (Drunk, Drugged, Diabetic, Deranged, Domestic) we have to keep a better watch over our shoulder.

And as far as protection from litigation after the fact.......... if a person loses in criminal court, it is very, very difficult for them to win in a civil suit. So pursue charges if the need arises because a civil suit may take years before they decide to sue. 

The level of force in this situation would be considered a low-level, empty hand assault response. I would not have been justified in striking him with an object or using a "weapon". Once space was created there was no justifiable reason to strike a second time.

Remember, it's not a fight. I cant' be a willing participant then claim to be a victim.


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## Second (Jan 1, 2009)

run and scream like a little school girl....  NO

he's been drinking for a few hours so he might be a little slugish
after he would of raised his voice at me the first time i would keep an eye on him till I was back in the truck

I'd say redirect, trip, or pop him one good time with my notebook or clip board


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## artman17847 (Jan 1, 2009)

....fight or flight time....


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## DT4EMS (Jan 1, 2009)

You are both correct. Back up two responses. I added some at the same time you two were posting 

Kip


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## Shishkabob (Jan 1, 2009)

Push since there is no getting away, try to step aside, let the cop in, then assist the cop if asked for help.


Believe it or not, was in a similar situation during clinicals.  (waits for complaints of "you shouldn't be doing that" and so on).  Long story short-- drunk driver backed in to a kitchen in his neighborhood, only 1 PD on scene with us and a fire truck, and a few rowdy neighbors.


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## DT4EMS (Jan 2, 2009)

Linuss said:


> Push since there is no getting away, try to step aside, let the cop in, then assist the cop if asked for help.
> 
> 
> Believe it or not, was in a similar situation during clinicals.  (waits for complaints of "you shouldn't be doing that" and so on).  Long story short-- drunk driver backed in to a kitchen in his neighborhood, only 1 PD on scene with us and a fire truck, and a few rowdy neighbors.



Here is a clip of what was used.
http://paramedictv.ems1.com/Clip.aspx?key=64264D1C82C5303E


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## Explorer127 (Jan 8, 2009)

That would be quite scary...

I'd be pretty much hoping the cop would do something and I'd probably push the panic button on the radio..


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## marineman (Jan 8, 2009)

Hind sight is 20/20 and I know we already have the correct answer but as soon as the guy got belligerent the first time I would have completed my assessment and any appropriate treatment outside while the officer made sure the guy stayed inside. 

If somehow I was at the point of being bottle necked in the door I can say I agree with DT's actions. Quick palm strike to the sternum does a heck of a job giving you a little time to boogy.


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## BossyCow (Jan 8, 2009)

My plan is always going to be to get behind the cop. I also have a high priority to being at the door before the cop. 

This scenario sounds a lot like the one about the two guys trying to outrun a bear.. the one guy says.. "We can run faster than that bear" the other guy replies.. "I don't have to run faster than the bear.. I just have to run faster than you!"


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## Jon (Jan 8, 2009)

I'm sorry I missed this.

If I'm getting an AMA signed, I am holding a clipboard or pad of forms in my hand. In my mind, I'm going to throw the paperwork at the subject as a distraction and then try to get out of the way.


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## DT4EMS (Jan 8, 2009)

I hope nobody gets the wrong idea here. 

In over 18 years of EMS I have only had to use force a very, very few times. More often than not being prepared, good customer service and paying attention to my surroundings have kept me safe.

As far as this incident goes........... there was a pretty lengthy time frame from the time the guy was told to shut up and the AMA being obtained.

The officer had the father in the doorway speaking to him. It is unlikely I would have received a positive response from the officer, dad and my partner had I have told them to  "move" so I could get out the door. 

In understanding the legal principles of "reasonable force" a quick palm heel to center mass was "reasonable" based on the "totality of the circumstances" known to me at the time.

Remember not every person that mouth's you gets physical and not every person that smiles at you is kind to you.

I am going to post more scenarios. Some will be taken from stories that were told to me, emailed to me or made the news. From them we will begin to establish one of the "4" areas in DT-4-EMS. That is training the Mind.


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## traumateam1 (Jan 9, 2009)

Can't I just use my TASER? :sad:


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## Explorer127 (Jan 9, 2009)

traumateam1 said:


> Can't I just use my TASER? :sad:



lol do you really carry a taser with you?


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