Grim scene - bystander/first responder GSW scenario

[VFlutter]

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.

 

[Swimfinn]

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

 

[karaya]

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.

 

[VFlutter]

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.

 

[shiroun]

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.

 

[karaya]

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.

 

[firetender]

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.

 

[GaMedic]

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..

 

[Tigger]

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.

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.

 

[karaya]

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

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

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.

 

[karaya]

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.

 

[PVC]

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.

 

[shiroun]

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?

 

[Doczilla]

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.

 

[Remeber343]

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

 

[mycrofft]

Now, THIS is a GRIMM scene

 

[PVC]

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.

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.

 

[MRSA]

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.

 

[Jon]

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.