Scene safety and interdepartment panic...

[Mongoose]

My partner and I (both EMT-B rookies) responded to a stabbing/gsw at 0230, 3 miles up a one lane dirt road. It was in a rich neighborhood, a bunch of business/movie execs that liked the peace and quiet and horses etc. Dispatch told us that we were clear to enter per county fire. Awesome. Unfortunately it was wishful thinking. The father of the stabbing victim was retired city fire and was apparently giving dispatch an earful. As a result dispatch thought we were clear to enter. This was approx 5min out, we lost comm soon after due to canyons.

So we thought we were clear. Long story short we rolled up on the crime scene mere minutes after a second patient was shot. There was an active shooter at large, my partner and I were by ourselves, sheriff was disorganized, we didn't have radio, data terminal, or cell phone reception, nor egress (blocked by sheriff). We staged in the best possible spot until some sergeant came by screaming at the top of his lungs for us to get in and treat the patient. We are issued class IIIA ballistic vests but they are typically used for civil unrest and were back at our station. While I turned the rig around sheriff blew by in pursuit of one of the suspects who almost took out my driver-side mirror. Follow up deputies AGAIN closed off egress and by that time our only route to clear the one lane road was into the scene where we proceeded (against my better judgment).

My question, as a rookie, is where do I draw the line regarding scene safety? Do I throw the rig in park, stand on the brake and refuse to enter the scene even though I'm blocking the entire road and sheriff can't get around me? I wasn't thrilled about rushing into an active shooter situation. Since I did however, do I blame that on a brash, ricky-rescuer tendency or did I legitimately not have much of a choice?

(We rolled up to find a 20yo male w/tension pneumo due to a stab under his left nipple. ALS arrived a few minutes after us and the medic performed a needle thoracostomy too close to his heart, later sending him into v-tach and requiring him to lance him a second time, higher up. We had a half hour ETA to the ER and fire was having trouble getting through to medical control. It wasn't the greatest of nights, on top of that my partner got carsick in the back while enroute to the ER and I had a hysterical mother in the passenger seat).

 

[flhtci01]

Rule #1 - Scene safety

Responding to a stabbing/gsw or other potential crime scene, I want the all clear from the LLEA, not the fire department or someone who thinks they know what is going on. I look at it as the non-LEO could either be the person with a weapon or a hostage. The LLEA should have the area surveyed and secured before the 'all clear'.

Read http://www.emtlife.com/showthread.php?t=9158 about the dangers of allowing passengers ride in the rig from a crime scene.

Sounds like you got very lucky and have learned about iffy situations.

 

[MedicMonty]

Agree with the previous poster. Not much you can do now except pat yourself on the back for doing the best you can with what you had and learn the lessons:

1) Don't care what dispatch tells me, if I don't hear that a LE agency is the one clearing the scene, I don't enter the same block, much less the drive. If I do approach, and don't see at least one or two squad cars, I keep driving or turn right around and leave.

2) Even if I was blocked in, I'm still not going in the house. "Sorry, Sarge, let me know when every room, closet, attic, pile of clothes, bathtub, under-the-bed-monster-hiding-spot and clothes dryer d*** sure doesn't have a shooter in it, and I'll be glad to go in. Until then, I'm gonna make like a hole in the air right here where I am and keep my head on a swivel." Do that just once or twice and they'll learn not to give you crap unless the scene is truly secure because they know they'll just be wasting time going out to ask you if they haven't cleared the house.

The bottom line is, you have absolutely zero responsibility to ANY patient, legally or ethically, unless and until you feel like your safety can be ensured. No matter what level or service you practice at, whether it's a crime scene, hazmat, unstable MVA, whatever - call the resources that can mitigate whatever unsafe situations exist and turn yourself into an EMS brick somewhere safe until YOU are satisfied that it's safe to enter the scene. If that's going to be a while (big house and only one or two deputies, hazmat that will take a while to make safe, etc.), tell them you'll be happy to treat their patient as soon as someone brings the patient to you.

Good job getting home. Learn the lessons (the same way many of us had to) and talk it over with your superiors to see if they can't help keeping it from happening again.

NJM

 

[Ridryder911]

My partner and I (both EMT-B rookies) responded to a stabbing/gsw at 0230, 3 miles up a one lane dirt road. It was in a rich neighborhood, a bunch of business/movie execs that liked the peace and quiet and horses etc. Dispatch told us that we were clear to enter per county fire. Awesome. Unfortunately it was wishful thinking. The father of the stabbing victim was retired city fire and was apparently giving dispatch an earful. As a result dispatch thought we were clear to enter. This was approx 5min out, we lost comm soon after due to canyons.

So we thought we were clear. Long story short we rolled up on the crime scene mere minutes after a second patient was shot. There was an active shooter at large, my partner and I were by ourselves, sheriff was disorganized, we didn't have radio, data terminal, or cell phone reception, nor egress (blocked by sheriff). We staged in the best possible spot until some sergeant came by screaming at the top of his lungs for us to get in and treat the patient. We are issued class IIIA ballistic vests but they are typically used for civil unrest and were back at our station. While I turned the rig around sheriff blew by in pursuit of one of the suspects who almost took out my driver-side mirror. Follow up deputies AGAIN closed off egress and by that time our only route to clear the one lane road was into the scene where we proceeded (against my better judgment).

My question, as a rookie, is where do I draw the line regarding scene safety? Do I throw the rig in park, stand on the brake and refuse to enter the scene even though I'm blocking the entire road and sheriff can't get around me? I wasn't thrilled about rushing into an active shooter situation. Since I did however, do I blame that on a brash, ricky-rescuer tendency or did I legitimately not have much of a choice?

(We rolled up to find a 20yo male w/tension pneumo due to a stab under his left nipple. ALS arrived a few minutes after us and the medic performed a needle thoracostomy too close to his heart, later sending him into v-tach and requiring him to lance him a second time, higher up. We had a half hour ETA to the ER and fire was having trouble getting through to medical control. It wasn't the greatest of nights, on top of that my partner got carsick in the back while enroute to the ER and I had a hysterical mother in the passenger seat.

There are so many things with this scenario, one doesn't know where to begin; except to thank God that you are alive and that the patient apparently lived.

Why would one ever place two rookies (that obviously doesn't know what to do) together? Time to suggest to management albeit it sounds like it might be typical as what LEO would yell to enter into a scene without the suspect not being apprehended? If a EMS offers you ballistic vests apparently its crime rate is high enough to warrant to wear one, not leave in the station.

Then having a carsick EMT? ...

Appears to me, someone needs a big broom and make a clean sweep. Start with in-depth in-services on scenarios and education of scene safety and awareness. One could only assume that the medical knowledge would be equal to the knowledge of scene safety.

R/r911

 

[traumateam1]

As MedicMonty said:

Don't care what dispatch tells me, if I don't hear that a LE agency is the one clearing the scene, I don't enter the same block, much less the drive. If I do approach, and don't see at least one or two squad cars, I keep driving or turn right around and leave.

And flhtci01:

Responding to a stabbing/gsw or other potential crime scene, I want the all clear from the LLEA, not the fire department or someone who thinks they know what is going on. I look at it as the non-LEO could either be the person with a weapon or a hostage. The LLEA should have the area surveyed and secured before the 'all clear'.

First of all, it was you and another rookie, a very simple mistake that could have had a major consequence, luckily it didn't. A rule I like to go by what MedicMonty said. I don't care who "clears" the scene, if it isn't the police than I do not enter. As flhtci01 said, it could be anyone. The shooter him/herself or a hostage, if I don't get an all clear from the police than I do not enter the scene.
It was a pretty cr***y situation, no communications, two rookies. Luckily you didn't get hurt, or killed.
Good luck with your career, and stay safe.
Remember the number 1 rule: Our Safety (Scene Safety).

 

[Mongoose]

Why would one ever place two rookies (that obviously doesn't know what to do) together? Time to suggest to management albeit it sounds like it might be typical as what LEO would yell to enter into a scene without the suspect not being apprehended? If a EMS offers you ballistic vests apparently its crime rate is high enough to warrant to wear one, not leave in the station.

Then having a carsick EMT? ...

The LLEA (in this case county sheriff) has a reputation for being subpar. The four shifts that work second half of the week, nights, are mostly rookies hired within the last six months. My partner turned 18 in august, has just begun to shave (literally) and has frozen up four times in the last month we've been working together. The supervisors were short one so my station was the one without access to the cage w/the vests. All of this to get my stupid experience quota for medic heh.

I've been working for about three months now and this was my fourth active shooter out of countless stabbing/gsw responses. Typically we arrive before Fire because we patrol our posted areas instead of deploying from stations. The SOP is to stage and wait for Fire. They then stage until cleared to enter by LEO's, then they enter and confirm, then they call us in via tactical or dispatch. This is why we were confused when notified that we were "cleared to enter per county fire" (which again was misinformation) and discovered the scene waiting for us. Typically the three-tiered approach works very well, this was the first "major potential incident" my company has had in a while. On the other three I've been on, things have worked smoothly and efficiently and we've been out of there within the platinum ten.

Thanks for your input, MedicMonty I like your advice on being an EMS brick. I'll keep that in mind. I guess the first fubar situation had to happen sooner or later.

 

[Ridryder911]

I've seen and worked at places like that. Fortunately, alike you we escaped major hurdles and danger. Hopefully, there will be some type of FTO that help assist you.

R/r 911

 

[knxemt1983]

My partner and I (both EMT-B rookies) responded to a stabbing/gsw at 0230, 3 miles up a one lane dirt road. It was in a rich neighborhood, a bunch of business/movie execs that liked the peace and quiet and horses etc. Dispatch told us that we were clear to enter per county fire. Awesome. Unfortunately it was wishful thinking. The father of the stabbing victim was retired city fire and was apparently giving dispatch an earful. As a result dispatch thought we were clear to enter. This was approx 5min out, we lost comm soon after due to canyons.

So we thought we were clear. Long story short we rolled up on the crime scene mere minutes after a second patient was shot. There was an active shooter at large, my partner and I were by ourselves, sheriff was disorganized, we didn't have radio, data terminal, or cell phone reception, nor egress (blocked by sheriff). We staged in the best possible spot until some sergeant came by screaming at the top of his lungs for us to get in and treat the patient. We are issued class IIIA ballistic vests but they are typically used for civil unrest and were back at our station. While I turned the rig around sheriff blew by in pursuit of one of the suspects who almost took out my driver-side mirror. Follow up deputies AGAIN closed off egress and by that time our only route to clear the one lane road was into the scene where we proceeded (against my better judgment).

My question, as a rookie, is where do I draw the line regarding scene safety? Do I throw the rig in park, stand on the brake and refuse to enter the scene even though I'm blocking the entire road and sheriff can't get around me? I wasn't thrilled about rushing into an active shooter situation. Since I did however, do I blame that on a brash, ricky-rescuer tendency or did I legitimately not have much of a choice?

(We rolled up to find a 20yo male w/tension pneumo due to a stab under his left nipple. ALS arrived a few minutes after us and the medic performed a needle thoracostomy too close to his heart, later sending him into v-tach and requiring him to lance him a second time, higher up. We had a half hour ETA to the ER and fire was having trouble getting through to medical control. It wasn't the greatest of nights, on top of that my partner got carsick in the back while enroute to the ER and I had a hysterical mother in the passenger seat).

where I work we do not enter the scene until PD has cleared us to come in. remember what we were all taught in EMT school "my safety is number one". We had an incident last week where one of the PD's in our area refused to respond on a call in which someone was threatening to stab the family and himself because it was the second time that day that they had called about the same issue. Our dispatch told the medic unit to go in since PD wouldn't go. The medic unit got close and called staged, and went on to say they would be staged until PD went. That is a perfect example of our company rules. If not PD cleared on dangerous calls, then we stage until further notice.

until they give me a vest, gun, taser, and the training to use such, I will continue to stage. Thats my 2 cents

 

[mycrofft]

Tactical problems

Due to location, lost the warm fuzzy of commo back to base. Lose commo to local LE as well? Any intercommo protocols worked out?

Sounds like the "too close/too far" situation, either have to "stage" too far out with no way to be called in, or stage too close, due to road etc. This is also with big area stuff like standby at potential BLEVE scenes or bomb threats...how far is too far, versus how far for safety?

When I was in on my first one of those "where'd he go?" deals, LE and fire and our ambulance went in together, but we arrived just after they did. House was saturated. Turned out perp was three miles away trying to hitch a ride covered with blood.

 

[Mongoose]

Due to location, lost the warm fuzzy of commo back to base. Lose commo to local LE as well? Any intercommo protocols worked out?

Sounds like the "too close/too far" situation, either have to "stage" too far out with no way to be called in, or stage too close, due to road etc. This is also with big area stuff like standby at potential BLEVE scenes or bomb threats...how far is too far, versus how far for safety?

When I was in on my first one of those "where'd he go?" deals, LE and fire and our ambulance went in together, but we arrived just after they did. House was saturated. Turned out perp was three miles away trying to hitch a ride covered with blood.

Some of our rigs have Fire's tactical channel on scanners, but this was a 2001 model so it didn't. If Fire managed to contact dispatch we obviously couldn't hear anything from them. We are not on the LE bands out here.

 

[mycrofft]

Be tempting to carry some LMR's

They toss you one or vice versa, then back off.

That would be even hairier if there were fire involved. Keep in the black!

 

[lizhiniatsos]

if I'm dead today my children don't have a mother tomorrow...nor will I be around to serve the rest of my potential, future patients....I've been in this long enough to know that I have to take responsibility for knowing how to keep myself, my crew and my patient safe from the time of dispatch until we all go home...sometimes that means standing up to someone with higher authority, a prettier badge etc....sometimes that means entering a scene against all odds because it's the right thing to do even tho' it goes against all the 'rules'...know the rules...know the boundries...know the consequences of the varying actions you might choose to take...BEFORE you take them...and do your part to change the system you're working in before someone gets maimed/injured/killed....if you know it's broken and don't fix it....well...\
anyhoo...I'm glad you all got outta that one alive and well, it doesn't always work out so beautifully~

 

[fma08]

PD clears the scene, end of story. Fire can yell all they want, and if they want to go in, that's their decision. Can't help anyone if you're dead.