# Grim scene - bystander/first responder GSW scenario



## Rostov (Aug 24, 2012)

You are a bystander to a drive-by shooting at midnight in a city. At least 20 shots are fired, sounding like they're from handguns. After hiding behind a wall, and waiting for the gunmen to drive away, you dial 911 while trotting toward the scene. There is a crowd already gathering, and you see two female victims on the sidewalk. Both are approximately in their thirties.

Victim A: lying on the curb, unconscious, in a massive pool of blood. Respirations resembling agonal--gasping with periods of apnea in between. Radial pulse is thready for a few seconds, but literally stops under your fingers. No obvious head or extremity wounds.

Victim B: screaming her head off, sitting on the curb next to Victim A. She's holding pressure with one hand on a LLQ GSW. There is a wound on her head as well which is bleeding profusely. Extremely agitated.

The crowd is not interested in helping you out. You are the only person who's trying to do anything for these people. The police could be as many as five minutes away.

--


I'm interested in what the community has to say about triage protocols and how you would act in this particular situation. Who would you treat? And how? You don't have any gloves or CPR mask on your person. Let me know if you have any questions.


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## Remeber343 (Aug 24, 2012)

I would promptly trot in the other direction. Mainly. Because I dont want led poisoning and secondly I'm not on duty. Mainly because of the led poisoning though.  And if it's a drive by, it's probably hang related.  And if I don't have BSI I'm not touching those little gang bangers, who knows what nasties they have seeping out of them. My triage plan: call 911, leave, find some pie, and go to bed. Mainly because pie solves a lot of the worlds problems.


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## Martyn (Aug 24, 2012)

BSI...scene NOT safe...


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## NomadicMedic (Aug 24, 2012)

Agreed with the above. 911 and move promptly in the other direction.


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## Akulahawk (Aug 24, 2012)

Given the circumstances, I would not have intervened. That scene is not safe. As far as the victims are concerned, #1 is dead, #2 will need care, possibly rapidly. However, I would not know that given that I would not be anywhere near the area… I would be someplace else that is far safer. Given my particular status as a CCW holder, I would call 911 and find a good place to hide, preferably somewhere else. I would not attempt to go in and make this scene safe. That is the job of law enforcement. My number 1 overriding priority is safety of myself and that of my family.


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## rwik123 (Aug 24, 2012)

Remeber343 said:


> I would promptly trot in the other direction. Mainly. Because I dont want led poisoning and secondly I'm not on duty. Mainly because of the led poisoning though.  And if it's a drive by, it's probably hang related.  And if I don't have BSI I'm not touching those little gang bangers, who knows what nasties they have seeping out of them. My triage plan: call 911, leave, find some pie, and go to bed. Mainly because pie solves a lot of the worlds problems.



1) it's lead not led

2) I don't know how you'd get lead poisoning...

(yes I know bullets have lead but that's insignificant) 



Someone just got smoked by a gang banger. Why would you want to go trotting on scene? It'll be just peachy when he rounds the block for a second drive by and kills you while you try to play hero.


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## gw812 (Aug 24, 2012)

Rapid self-extrication is indicated. Not equipped to manage scene nor patients.


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## PVC (Aug 24, 2012)

Akulahawk said:


> Given the circumstances, I would not have intervened. That scene is not safe. As far as the victims are concerned, #1 is dead, #2 will need care, possibly rapidly. However, I would not know that given that I would not be anywhere near the area… I would be someplace else that is far safer. Given my particular status as a CCW holder, I would call 911 and find a good place to hide, preferably somewhere else. I would not attempt to go in and make this scene safe. That is the job of law enforcement. My number 1 overriding priority is safety of myself and that of my family.



I would not get involved as a bystander in the scenario as you have presented it.

If your question is about triage and we have waved our scene safe and BSI "magic wand" I agree with Akulahawk. Patient one will not benefit from CPR, she is dead.  Patient 2 would need ALS attention.


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## FLdoc2011 (Aug 24, 2012)

rwik123 said:


> 2) I don't know how you'd get lead poisoning...



I think he was referring to getting shot.... "lead poisoning"


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## bahnrokt (Aug 24, 2012)

I don't have to decide what to do because I don't go for walks through gang neighborhoods at midnight..

20 shots and only 2 hit their mark.  Stop holding guns sideways.


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## Asclepius911 (Aug 24, 2012)

I've heard stories that sometimes these gang bangers will follow the ambulance to finish up their job, to make sure their target dies. My biggest concern would be scene safety!! ( including BSI, HIV or AIDS is the first thing that comes to mind).


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## Aidey (Aug 24, 2012)

Why HIV? Because of the blood? What are you planning on doing, slicing your own palm open and then holding pressure with your bare hand? Hepatitis is more likely anyway. 


And it isn't HIV or AIDS. You can only catch HIV, AIDS has to develop after that.


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## VFlutter (Aug 24, 2012)

bahnrokt said:


> I don't have to decide what to do because I don't go for walks through gang neighborhoods at midnight..
> 
> 20 shots and only 2 hit their mark.  Stop holding guns sideways.



+1 

a large group of people standing around? Get the F out of here, I am not going anywhere near that scene.


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## Asclepius911 (Aug 24, 2012)

I was planning in diving into to the puddle of blood  , great for the skin lol


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## PVC (Aug 24, 2012)

"Anatoly Orlov: Is this how you want to be remembered?"
"Yuri Orlov: [chuckles] I don't want to be remembered at all. If I'm being remembered, it means I'm dead." Lord of War Quote


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## Asclepius911 (Aug 24, 2012)

"The first and most important rule of gun-running is, never get shot with your own merchandise."-Jury Orlov


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## Rostov (Aug 24, 2012)

rwik123 said:


> 1)
> Someone just got smoked by a gang banger. Why would you want to go trotting on scene? It'll be just peachy when he rounds the block for a second drive by and kills you while you try to play hero.



Where does this "second round" idea come from? I've never heard of this phenomenon. As I understand it, the strategy of the drive-by is to attack hard and fast, then GTFO before the cops arrive. The cars containing the shooters accelerated hard going due south, running through stop signs. Essentially giving no indication that they were planning on making a U-turn that night.

This doesn't make the scene safe. But I think the likelihood of a repeat attack is extremely low.


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## STXmedic (Aug 24, 2012)

So this happened to you recently? What was your course of action?


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## Medic Tim (Aug 24, 2012)

Rostov said:


> Where does this "second round" idea come from? I've never heard of this phenomenon. As I understand it, the strategy of the drive-by is to attack hard and fast, then GTFO before the cops arrive. The cars containing the shooters accelerated hard going due south, running through stop signs. Essentially giving no indication that they were planning on making a U-turn that night.
> 
> This doesn't make the scene safe. But I think the likelihood of a repeat attack is extremely low.



 I would gtfo of there as soon as I could. Calling 911 would be done once I feel it is safe to do so.  A slim to nil chance of them returning to check or finish the job is enough for me to get out of there.If you want to play ricky rescue though be my guest.


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## VFlutter (Aug 24, 2012)

Rostov said:


> Where does this "second round" idea come from? I've never heard of this phenomenon. As I understand it, the strategy of the drive-by is to attack hard and fast, then GTFO before the cops arrive. The cars containing the shooters accelerated hard going due south, running through stop signs. Essentially giving no indication that they were planning on making a U-turn that night.
> 
> This doesn't make the scene safe. But I think the likelihood of a repeat attack is extremely low.



Ya but what about the crowd? You are going to trust that they are all unarmed and have no intention to harm you? 

Are you sure it was due south? I heard most drive by gangsters like to head in a northeastern direction


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## PVC (Aug 24, 2012)

Rostov said:


> Where does this "second round" idea come from? I've never heard of this phenomenon. As I understand it, the strategy of the drive-by is to attack hard and fast, then GTFO before the cops arrive. The cars containing the shooters accelerated hard going due south, running through stop signs. Essentially giving no indication that they were planning on making a U-turn that night.
> 
> This doesn't make the scene safe. But I think the likelihood of a repeat attack is extremely low.



Some gangs are wicked organized. Depending on where you are at a secondary is possible and a serious threat. The onsite risk assessment is the key. How do you know there is not a second car waiting for a crowd to gather before making their pass?


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## Doczilla (Aug 24, 2012)

Aidey said:


> Why HIV? Because of the blood? What are you planning on doing, slicing your own palm open and then holding pressure with your bare hand? Hepatitis is more likely anyway.
> 
> 
> And it isn't HIV or AIDS. You can only catch HIV, AIDS has to develop after that.



Nope. Full blown AIDS. 60% of the time, works EVERY time.


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## Tigger (Aug 24, 2012)

Asclepius911 said:


> I've heard stories that sometimes these gang bangers will follow the ambulance to finish up their job, to make sure their target dies. My biggest concern would be scene safety!! ( including BSI, HIV or AIDS is the first thing that comes to mind).



While doing my basic clinicals the hospital I was at went into lockdown after armed gang members were arrested a few blocks from the hospital because they were following the ambulance too closely trying to finish off the patient. Given that they couldn't lock the hospital down forever, when Flight for Life cleared with their patient, they took the (apparently minor) GSW patient back to their base at a Level IV across the county. Bad guys never figured that one out.

In regards to this scenario, there is no way in hell I am involving myself in it beyond calling 911 while driving quickly in the other direction.


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## STXmedic (Aug 24, 2012)

doczilla said:


> nope. Full blown aids. 60% of the time, works every time.


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## Handsome Robb (Aug 24, 2012)

Rostov said:


> Where does this "second round" idea come from? I've never heard of this phenomenon. As I understand it, the strategy of the drive-by is to attack hard and fast, then GTFO before the cops arrive. The cars containing the shooters accelerated hard going due south, running through stop signs. Essentially giving no indication that they were planning on making a U-turn that night.
> 
> This doesn't make the scene safe. But I think the likelihood of a repeat attack is extremely low.



You're very likely to get yourself shot my friend. There's a reason we get PD escorts and armed guards at the ER when dealing with victims of suspected gang violence. Like others have said, you are messing with their goal, they don't like that. 

Turn around and walk away. I wouldn't know that patient number one is dead because I'd never get close enough to find out. 

If this happened when I'm on duty and PD cleared the scene first #1 would be left dead on scene and #2 would be cruising towards a Trauma Center pretty quickly.


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## Doczilla (Aug 24, 2012)

The fact that youre even debating the safety of attenting to targets of organized crime for the benefit of providing care that is more likely to make you feel better than make them better is.... Evidence of the need for an attitude readjustment. 

Go ahead if you want to. Hold pressure on that scalp wound. Stare at that abdominal wound. It's not going to get them into surgery faster. 

you may be dumbfounded that the crowd was unhelpful , but they were most likely dumbfounded that a stranger appeared to conspicuously render aid to someone who a group of armed criminals want dead. They don't care about that person. They don't care that you're an EMT. 

You may want to make a difference,you may want to feel like you showed courage in a perilous situation, but all you're going to do is walk away with bloody hands and a target on your back.


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## PVC (Aug 24, 2012)

Rostov said:


> Where does this "second round" idea come from? I've never heard of this phenomenon. As I understand it, the strategy of the drive-by is to attack hard and fast, then GTFO before the cops arrive. The cars containing the shooters accelerated hard going due south, running through stop signs. Essentially giving no indication that they were planning on making a U-turn that night.
> 
> This doesn't make the scene safe. But I think the likelihood of a repeat attack is extremely low.



Are you in a conundrum between safety and helping your homies? 

What is your relationship to this subculture that would make you want to take such a risk?

Everyone wants to "do good" in society but getting dead is not good for anyone.


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## leoemt (Aug 24, 2012)

I am trained for this and I would high tail it out of the area. Ever wonder why cops show up in force? This would be a call where, in my area, Several jurisdictions would be responding and EVERYONE on scene would be proned out on the ground and searched then questioned. I wasn't a cop in the "hood" and this would be a rare occurance for us. For cops who are used to this the tactics might be different. 

A suspect drove up and opened fire. Obviously those people did something to piss them off. If a group is already forming chances are said group is friends, relatives, homies, etc. of the victims. Chances are VERY high that they would retaliate in a heart beat and you are likely going to be the target. 

The dumbest thing you can do is try to help or identify yourself as an EMT or Medic. If the group has any affiliation with the victims, they are likely going to take their anger out on you if you can't save the victims. 

Why would you even put yourself in a situation like this when the police are going to respond in numbers with AR-15's? Deathwish?


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## Remeber343 (Aug 24, 2012)

rwik123 said:


> 1) it's lead not led
> 
> 2) I don't know how you'd get lead poisoning...
> 
> (yes I know bullets have lead but that's insignificant)



I apologize for saying led instead of lead, unfortunately I'm not as perfect as I thought I was :wacko: And as for the lead poisoning, I was being a smart :censored::censored::censored: But, I guess it must have gone over your head, I also apologize for that.  Maybe someday you'll learn to just have a chuckle instead of having to correct stuff  I have been on many shootings, and they die form lead poisoning, not from bleeding out or other life threats.  (That was being sarcastic, they don't actually die from lead poisoning)


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## rwik123 (Aug 24, 2012)

Remeber343 said:


> I apologize for saying led instead of lead, unfortunately I'm not as perfect as I thought I was :wacko: And as for the lead poisoning, I was being a smart :censored::censored::censored: But, I guess it must have gone over your head, I also apologize for that.  Maybe someday you'll learn to just have a chuckle instead of having to correct stuff  I have been on many shootings, and they die form lead poisoning, not from bleeding out or other life threats.  (That was being sarcastic, they don't actually die from lead poisoning)



Makes sense now hahah...didn't pick up on the humor when I posted at 3 in the morning.


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## Rostov (Aug 25, 2012)

PVC said:


> Are you in a conundrum between safety and helping your homies?
> 
> What is your relationship to this subculture that would make you want to take such a risk?



I've been watching as this thread fills up with progressively more racist comments, and it is interesting. You ask about my relationship to the "subculture." The culture of violence? My relationship to it is that it happened right in front of me, to other human beings. These people were my neighbors. Yes, I live in the hood. No, these people were not my "homies." They were strangers.

And as far as callously blaming the victims, you might not want to jump to any conclusions. They were innocent bystanders to the real targets. Perhaps I acted as I did because I could have been in their shoes.

Would you want everyone to leave you to bleed to death on the sidewalk while waiting for the police to arrive?


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## Medic Tim (Aug 25, 2012)

Rostov said:


> I've been watching as this thread fills up with progressively more racist comments, and it is interesting. You ask about my relationship to the "subculture." The culture of violence? My relationship to it is that it happened right in front of me, to other human beings. These people were my neighbors. Yes, I live in the hood. No, these people were not my "homies." They were strangers.
> 
> And as far as callously blaming the victims, you might not want to jump to any conclusions. They were innocent bystanders to the real targets. Perhaps I acted as I did because I could have been in their shoes.
> 
> Would you want everyone to leave you to bleed to death on the sidewalk while waiting for the police to arrive?



If it was putting them at risk..... Which it is and the fact that they really can't do anything for me.....i would not expect or want help until it was safe.


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## PVC (Aug 25, 2012)

Rostov said:


> I've been watching as this thread fills up with progressively more racist comments, and it is interesting. You ask about my relationship to the "subculture." The culture of violence? My relationship to it is that it happened right in front of me, to other human beings. These people were my neighbors. Yes, I live in the hood. No, these people were not my "homies." They were strangers.
> 
> And as far as callously blaming the victims, you might not want to jump to any conclusions. They were innocent bystanders to the real targets. Perhaps I acted as I did because I could have been in their shoes.
> 
> Would you want everyone to leave you to bleed to death on the sidewalk while waiting for the police to arrive?



*Subculture*: A. the cultural values and behavioral patterns distinctive of a particular group in a society.
B. a group having social, economic, ethnic, or other traits distinctive enough to distinguish it from others within the same culture  or society. Dictionary.com

A subculture is any group of people, steel workers, poker players, police, EMS. It is not necessarily ethnicity related.
The slang word homie has been around so long it has been integrated into the American vernacular. 

The only guilty in a shootout are the shooters. Everyone else are victims.

If you helped that is your choice. If you don't want people's opinions you can consider not asking.  

I would not want anyone to bleed out anywhere, then again I would not want them to be shot in the first place. I most definitely don't want my family to loose one of their providers. I cannot control what other people's actions only mine.

Let's be nice. No need to imply people are something they are not.


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## GaMedic (Aug 25, 2012)

Pt 1. Dead
Pt 2. Needs treatment beyond what you would have on you off duty.


Best intervention you could do at this point would be turn and walk away. Call 911 (or appropriate number for your country) and give as much information as possible. Every detail you can remember from what you saw is important. Leave them with your contact information if they have any further questions and go home to your family without any extra holes in your body. :glare:


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## sirengirl (Aug 25, 2012)

bahnrokt said:


> 20 shots and only 2 hit their mark.  Stop holding guns sideways.



Forcibly reminds me of the day we were talking about some local gang violence, and my middle-aged Hispanic instructor stopped, took the IO gun out, cocked it sideways, and said, "N!&&@, I'll drill yo' a$$!" while toggling the drill trigger :rofl:


Agreed with 99% of posters here. Patient 1, sorry about your luck. Patient 2, sucks to be you right now, hopefully there's a good surgeon on call. I'd be requesting a Bambilance while getting away as quickly as I could. In my town, though, the huge emergency at 2am would most likely be some idiot calling the cops because his weed dealer cheated him....


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## VFlutter (Aug 25, 2012)

Rostov said:


> Would you want everyone to leave you to bleed to death on the sidewalk while waiting for the police to arrive?



Yes I would, I can hold pressure on my wound, which is the only thing you could do for me,  (unless i'm unconscious then I'm just :censored and wait for appropriate help.  No point in someone stupidly risking their own life to attemp to save mine. 

So you go up on scene and get shot while trying to assist. Now there is 3 patients instead of 2. Who is going to get treated first? The first patient is now definitely getting left for dead, your then possibly delaying care for the second so they can triage you. End result? Maybe both patients die, maybe even you. So what did you help? How is you being there with no equipment or support any type of help? In the end it's just more harm then good.


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## GaMedic (Aug 25, 2012)

Rostov said:


> I've been watching as this thread fills up with progressively more racist comments, and it is interesting. You ask about my relationship to the "subculture." The culture of violence? My relationship to it is that it happened right in front of me, to other human beings. These people were my neighbors. Yes, I live in the hood. No, these people were not my "homies." They were strangers.
> 
> And as far as callously blaming the victims, you might not want to jump to any conclusions. They were innocent bystanders to the real targets. Perhaps I acted as I did because I could have been in their shoes.
> 
> Would you want everyone to leave you to bleed to death on the sidewalk while waiting for the police to arrive?



You ask what us as professionals would do in a given situation. Then turn what we say into some form of racism. We as professionals look at situations differently than the average lay person. If you were willing to put yourself in danger to hold some random Joe or Jan's hand while they bleed out in front of you. I applaud you and feel sorry for you at the same time. It was or is a very careless move to put yourself in danger when in reality there isn't anything you can do without having equipment and medications. Once you are in EMS long enough you too will lose faith in humanity.


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## medichopeful (Aug 25, 2012)

FLdoc2011 said:


> I think he was referring to getting shot.... "lead poisoning"



And remember, it's "lead therapy" if the police shoot someone 

I kidd, I kidd!


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## DesertMedic66 (Aug 25, 2012)

Walk/jog/run in the other direction and call 9-1-1. Then debate moving away from that area (their aim sucks which means I could get shot while just watching TV). The scene is not safe and even for a GSW there isn't anything I am gonna do off duty.


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## firetender (Aug 25, 2012)

*Life is cheap; especially if unpaid!*

_(The following is the opinion of Russ Reina, a firetender, and does not reflect the views of the Community Leaders of this Forum or any other entity of which he is a participant.)_​ 
39 posts.

22 side comments from repeat posters in the thread, a couple of them with no vote, just comment, leaving...

17 "thumbs down" to the victim, Did we establish there was a victim there? Oh, I'm sorry, they're all Perps! Did anyone term the afflicted as "patients"? (I've been studying this thread too much already; you look, see what you find.) 

*Just to be sure, I'm going back to see if there were any dissenters.*

Nope *ZIPPO!* on the dissent; it's unanimous, no Thumbs Up, let them die!! 

You see, NOT A ONE of the respondents hinted that they would even get close enough to LOOK to see the condition of the women! Check this out yourself, this thread is actually worth studying if you really want to understand yourself in relation to the work!

On the "faith in humanity" side, 7 said they'd make the 9-1-1 call, and one said, "Calling 911 would be done once I feel it is safe to do so." How far away do you have to run, drive, crawl or hitchhike before that happens? Just curious, what ARE the protocols for that?

*The picture I hope I'm getting is once the shots were fired, you'd all be out of there. To be perfectly honest, so would I, I wouldn't stick around to go looking for the results I can guarantee you of that!* 

However, as I read the OP, he was in the middle of it. *It* sought *him* out. I don't care what you say; when you're in the middle of it EVERYTHING changes!



> ROSTOV: My relationship to it is that it happened right in front of me, to other human beings. These people were my neighbors.


 
It looks like the only person who would take the risk of finding out the level of danger that the victims are in was the OP and he was there.

Let's repeat; of 18 trained medical professionals (am I straining things here?) only O-N-E would be curious enough and have the common sense it takes to protect him/herself from injury -- YES, under those circumstances -- to actually get within a few feet of the PATIENT to make an assessment?

The other seventeen are beating feet away from the fallen.

Beautiful visual, don't you think?

The verdict is in; 20 shots fired into a crowd with only a couple hitting their mark means there is a targeted hit going on, one that is sure to have organized follow-up to make sure the shot get dead and, of course, any stupid :censored::censored::censored::censored::censored::censored::censored: that tries to lessen suffering gets popped (for sure, can't you see?).

Someday, all 17 of you (or those like you) will be in the middle of such a scene. Picture the 4th of July at the beach or a public New Year's Eve party, and carnage will be sure to occur; but I suspect it will be of the bystanders trampled while you all stampede for scenes safer than there!

I'm not judging y'all here as much as I'm facinated by how things have changed since I put down my gurney and you picked up cellphones!!

GaMedic said:



> Once you are in EMS long enough you too will lose faith in humanity.


 
That happened to me a long time ago, but I didn't think it would ever include EMS.

Live and learn, I guess! Just like too many people, I forget that EMS workers are human.

Something's happening to our species.


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## VFlutter (Aug 25, 2012)

Again my question is...what are you going to gain? You have no supplies. Is putting pressure on a wound with your hand really going to help or make a noticeable difference, especially in an abdominal GSW? No. Is your assessment going to help them? Eh, maybe help when the paramedics get there but they will likely do their own assessment anyway, so not really helpful. 

Is there something to lose in this situation? Absolutely. Getting injured or losing your life as well as making another patient for EMS. 

It's simple risk vs reward. And in this situation a lot of risk with little reward. 

I will help humanity by staying alive and putting in many more years of service instead of wildly risking my life for one patient.


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## Swimfinn (Aug 25, 2012)

Well said Chase. I agree 100% with that statement.


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## karaya (Aug 26, 2012)

Some of the responses here are just plain silly.  Clearly most of the responders that have posted here have not worked in high crime areas or have had very little to no exposure to such situations.

First responders are far more likely to be injured or killed in an ambulance crash than be shot on the streets.


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## VFlutter (Aug 26, 2012)

karaya said:


> Some of the responses here are just plain silly.  Clearly most of the responders that have posted here have not worked in high crime areas or have had very little to no exposure to such situations.
> 
> First responders are far more likely to be injured or killed in an ambulance crash than be shot on the streets.



Just to clarify are you talking about first responders as in an off duty person first on scene or first responders working as EMT/medics?

Two totally different situations.


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## shiroun (Aug 26, 2012)

karaya said:


> Some of the responses here are just plain silly.  Clearly most of the responders that have posted here have not worked in high crime areas or have had very little to no exposure to such situations.
> 
> First responders are far more likely to be injured or killed in an ambulance crash than be shot on the streets.



That's all well and good, but what about the ones who are shot?

Lets assume, for a second, that 1% of all EMS-work-related deaths/year are from shootings.

Do you REALLY want to take the chance of being in that 1%, especially when you're off-duty and could go do better things? Patient 1 is already dead, and patient two could survive the few minutes until ALS arrives. 

That scene IS NOT safe. I'd rather walk into a active domestic abuse house and duke it out then risk being on that scene, partly because I know I've got a chance against a pissed off drunk, versus the 0% chance I have of catching or deflecting bullets.

Sorry if I come off harsh, I just wanted to throw that point out there.


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## karaya (Aug 26, 2012)

shiroun said:


> That scene IS NOT safe. I'd rather walk into a active domestic abuse house and duke it out then risk being on that scene, partly because I know I've got a chance against a pissed off drunk, versus the 0% chance I have of catching or deflecting bullets.


 
You can't be serious? A domestic dispute situation is already an active hostile environment and you would rather duke it out with a drunk?  Now you're really asking for trouble.  This is what I mean about some of the silly responses here.

Anytime you come into close contact with a hostile subject your risk of injury is elevated substantially.  That shooting scenario is far safer than what you're describing here.


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## firetender (Aug 26, 2012)

shiroun said:


> Lets assume, for a second, that 1% of all EMS-work-related deaths/year are from shootings.


 
Now there's a great statistic that I'd like to see, I'm sure you can dig it up. AND, while you're at it, please fetch us the stats on the # of off-duty EMS personnel who get shot while rendering aid at drive-by shootings.

Then, maybe, we can see some reality. 

All that's showing here is fear.

And once again, get back to me after you've been in the middle of something like this and THEN tell me what you DID, not what you KNOW you'd do.


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## GaMedic (Aug 26, 2012)

karaya said:


> Some of the responses here are just plain silly.  Clearly most of the responders that have posted here have not worked in high crime areas or have had very little to no exposure to such situations.
> 
> First responders are far more likely to be injured or killed in an ambulance crash than be shot on the streets.



Well sir.. Lets see if you remember your steps to trauma assessment....

BSI
*SCENE SAFE*
MOI/NOI
Number of Pt
additional help
etc....

Now with that said, even if I was on duty I am not going on scene until the scene is secured. Why in the hell would I when off duty without any backup,equipment or medications sporting just my lucky pocket knife? Sorry I nor is anyone else MacGyver.  Will other people? I am sure they will.. But not me or my partner. I enjoy going home at night, and cowboy antics will catch up with you eventually. You want to bring up domestic disputes, well to correct you on that one, technically you are not supposed to  go on scene with those either until the scene is secure. SO or PD will secure the scene then call for EMS who is generally staged down the block. 

Now if you feel your service will back you if you break protocol and pay for damages received to you or your rig.. Go for it, but just remember that if you break protocol your *** is at their discretion. They could use you as a scape goat and terminate you on the spot for breaking protocol... In the end its what *YOU* as an individual can live with. Would it be unethical to just turn your back and act if you didn't see a thing? Yes it would. Would it be unethical to choose not to put yourself in harms way and risk becoming a pt yourself just to offer emotional support and direct pressure? Nope..


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## Tigger (Aug 26, 2012)

shiroun said:


> That's all well and good, but what about the ones who are shot?
> 
> Lets assume, for a second, that 1% of all EMS-work-related deaths/year are from shootings.
> 
> ...



For what it's worth you have much better chance of being injured/shot at a domestic abuse scene than the original scenario. 

Not sure what your point is here exactly, but do not trifle with domestics.


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## karaya (Aug 26, 2012)

GaMedic said:


> Well sir.. Lets see if you remember your steps to trauma assessment....
> 
> BSI
> *SCENE SAFE*
> ...


 
Thanks for the refresher course, but I don't recall signing up for the class.

All I'm saying is be open to changing situations where you have to determine what is safe for you and what is not. The original thread poster has this scenaro where we are part of the bystanders and not on duty. If I already "trotted" up to the scene then it would seem logical that I deemed the scene safe. I would most likely at that point stop and render whatever aid I could do.

Here's another point to consider; police presence doesn't always mean a safe scene. I've recently filmed paramedics on several shootings whereby the scene deteriorated with police arrival (crowds became more hostile, etc.) and the paramedics had to do a boot, scoot, and boogie with the patient. Always keep your nose into the wind to changing situations while on the scene even with police on the scene.


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## karaya (Aug 26, 2012)

ChaseZ33 said:


> Just to clarify are you talking about first responders as in an off duty person first on scene or first responders working as EMT/medics?
> 
> Two totally different situations.


 
I'm talking about both, but for the sake of argument, the original poster's scenario was about about an off duty situation whereby we are bystanders.  I agree these would be two totally different situations since while you are on duty you most likely would be dealing with an SOP on gunshot situations.


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## PVC (Aug 27, 2012)

Someone mentioned the thread expresses a lot of fear. Not really.

I would not say I work shootings often but the ones that I have worked on occasion have been active and in conjunction with LE. I have seen the warm zone go hot, and cold and hot again.  Fear is not the deal. I think it is more about experience and prudence.

I face the fiddler while on duty. When I am off duty I most likely will not get involved in a shooting incident. 

On duty, uniforms, the presence of an ambulance with lights running make a difference in the way a scene plays out. There are no guarantees but it does seem to make a difference.


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## shiroun (Aug 27, 2012)

Tigger said:


> For what it's worth you have much better chance of being injured/shot at a domestic abuse scene than the original scenario.
> 
> Not sure what your point is here exactly, but do not trifle with domestics.



Oh wow. My facts are off. My point was originally meant as rathering being hit then shot, but in-fact you're correct. I don't engage with anyone involved in a domestic, it was meant as a.. I guess difference?


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## Doczilla (Aug 27, 2012)

This is making my stomach turn. Monday morning quarterbacks are getting Monday morning quarterbacked. 

While I do agree that no one ever knows what they're going to do until the sh*t hits the fan, I still maintain this: 

The treatment you render with your bare hands is more likely to make YOU feel better than make THEM better. 

A full-blown firefight has considerations. A "fresh" shooting has considerations. Not everyone has a tactical mindset that allows you to critically think under stress. But before you do anything, ask yourself: 

"Is this truly going to make a difference?" 

That's all I've got.


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## Remeber343 (Sep 5, 2012)

Then we ask ourselves... Does anything we do, actually make a difference...?


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## mycrofft (Sep 5, 2012)

*Now, THIS is a GRIMM scene*


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## PVC (Sep 6, 2012)

Doczilla said:


> This is making my stomach turn. Monday morning quarterbacks are getting Monday morning quarterbacked.
> 
> While I do agree that no one ever knows what they're going to do until the sh*t hits the fan, I still maintain this:
> 
> ...



I agree and would add that there is no wisdom in a person that lacks tactical training  independently inserting themselves into a tactical situation. 

It will rarely end well and will usually complicate the scenario for those that are prepared. 

An old Spanish proverb said "cobbler to your shoes". Simple wisdom from the past.


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## MRSA (Sep 10, 2012)

I only read the first four responses but I agree

Scene safety. Get out. If you don't have equipment on you (and even if you did) theres nothing you can do.

You could get shot at. Where did those shots come from?? Will that person try to shot you for saving them? Its happened before.

Scene safety.

And even if you had a trauma bag and O2 unless your a medic (start an IV on a sidewalk, why not. Have the screaming patron hold BOTH IV bags ) there isnt much you can do besides for her buddy maybe prop her legs up for trendelenberg and even then what about cspine for GSW trauma and the possibility of bullets bouncing bout the body?

Too much for one EMT regardless of level of training. Call for help.


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## Jon (Sep 10, 2012)

karaya said:


> Some of the responses here are just plain silly.  Clearly most of the responders that have posted here have not worked in high crime areas or have had very little to no exposure to such situations.
> 
> First responders are far more likely to be injured or killed in an ambulance crash than be shot on the streets.



Ray,

I agree, but the OP's question was talking about being present off-duty. If I was on duty, I'd have plenty of friends onscene (additional EMS units, supervisor, likely fire, and a ton of cops). Being solo and off-duty, it's a different world.

First, if you're off duty, you should have no legal duty to act.

Some thoughts:
If you're hiding behind a wall, how do you know that all the shooters departed? Might there still be a shooter present on the scene you're walking into? Even if they are all gone, it's not unheard of for an attacker to come back and make sure the person is really dead.

If you don't have gloves, you shouldn't be touching anything wet, sticky, and not yours, for your own safety. That limits what you can do.

Another question - are you alone, or are you with others? Are you going to drag your boyfriend/girlfriend/family into this situation, too?

My initial response would be to depart the area quickly and calmly, worrying about me and mine. I'll call 911, get to someplace safe, and be a good witness for the cops. That's about all I'm equipped to do off-duty.


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