It seems like in these troubled economic times, more and more people are calling for EMTs to go above and beyond the call of duty. Which we’re perfectly happy to do, within reason. What falls outside the envelope of reason, you ask? Well first there was a story about Washington, D.C. EMTs and firefighters being asked to patrol high crime neighborhoods in the district at night, which I found to be a little distasteful (especially since there were three people injured in shootings near their patrol routes recently, calling into question both the safety and the efficacy of the policy). Then today I saw this lovely story about Ohio wanting to arm EMTs, and I gotta say that’s way over the line, even for me. And here’s why.

As some of you know, in my spare time (what’s left after writing for this site, at least) I’m a volunteer EMT for Fairfax County in Virginia. A couple nights every week a few of my close firends and I place an ambulance in service, meaning that we can be dispatched at any time to any place in the county for any medical emergency.

Last week I was hanging out in the fire station when I heard a neighboring company get dispatched for one of our boxes (FYI, a fire station’s area of responsibility is divided into “boxes,” and the assigned station is usually dispatched first to those boxes). At first I was disappointed, as it was getting a little late and I was bored sitting around with nothing to do. And then I heard the entire dispatch.

“Medic 440, Truck 440, Box 2108 for a shooting […] Stage pending P.D. instructions.”

Suddenly I was very, very happy that I wasn’t the one they tapped for that call. The county was very clear when I started riding that being armed while on duty was a big no-no, so even though I usually carry a concealed weapon when I’m in Virginia I am completely unarmed when I’m in uniform (except for the trauma shears). I quote from the SOP:

Firearms shall not be carried by on-duty personnel or on any Fire and Rescue Department equipment […]

And I completely agree with that policy for two very good reasons.

The first reason is that Fire & Rescue are not the police, and in order to do our jobs well we can’t be. When I roll up on an accident I couldn’t care less if you caused it. My priority is to save lives, ALL of the lives, regardless of any transgressions they committed.

The best example of where this separation comes in handy is when dealing with drug overdose patients. If you’re in an altered mental state, I need to assess very quickly what the cause is so I can set you straight. If you just shot up a needle full of heroin that’s information I need to know so I can get the naloxone ready; if you don’t tell me then there’s a good chance you’re going to die before I can get you to the emergency room.

In a situation where there’s one or two extremely high people in my ambulance, the one phrase that seems to magically extract that information in a hurry is “I’m not the police, I can’t turn you in for whatever you took.” It works like a goddamned charm. If EMTs start carrying guns, then that clear separation becomes a little murky. “You say you’re not a cop, but you carry a gun!” I hear the crackheads yelling in response.

I hear the Armed Intelligentsia responding, “If you’re able to be dispatched to a shooting at a moment’s notice, wouldn’t you want to be armed?” And the answer (coincidentally reason #2) is no, I wouldn’t. That’s the police department’s job.

I know there’s at least one EMT reading this blog, so say it with me buddy.

Scene Safe? BSI

Everything we EMTs do is off a checklist, and just like airline pilots have their pre-flight checks, EMTs have our master list of questions to ask ourselves. Any time we get dispatched the very first question we ask ourselves is “is the scene safe?” If the answer is no, we park some distance away and wait until it is. If you look back on the dispatch at the top of the article you’ll notice it tells them to “Stage pending P.D. instructions,” which is code for “wait until the police say it’s clear.”

I don’t care if you’re bleeding out, I’m going to park my ambulance down the block until the police clear me to proceed. The mantra of any good ambulance officer is “first my crew, then other first responders, then the patient, then the public.” It’s the order in which we care about people’s well being. You may be in trouble right now, but my crew and I do this day in and day out. Yes you may die, and that sucks, but my crew and I are going home at the end of the night so we can keep helping people in the future.

Would having armed EMTs mean they can go into dangerous situations sooner? Yes, it would. But it would be a horrible idea. When you’re on scene, once you’ve determined it’s safe the ambulance crew usually focuses all of their attention inwards towards the patient. We’re focused on saving their life and performing our interventions and not on the crowd or external threats. Our situational awareness encompasses an area about the size of a small truck, and that’s it. The police, on the other hand, should have their situational awareness focused outwards towards the crowd and emerging threats. There’s nothing they can do for our patient, and the only reason they’re on scene is to keep us safe. Arming EMTs sounds like an excuse to send fewer police per dispatch, and when all of the EMTs are distracted it provides an excellent opportunity for a shooter to finish the job they started (my patient).

To be clear, the story that started me down this rant was about arming EMTs during SWAT raids. There’s a specialization in EMS that trains medics to go in with SWAT teams, but until now they’ve always been unarmed. There was nothing in the story about arming medics in general.

But the second you hand a gun to an EMT, the entire foundation of trust we’ve built with the community goes crumbling down. No other service in the United States is invited into people’s homes when they’re at their most vulnerable, complete strangers showing up when they’re most needed to lend a helping hand. If the public thinks those strangers are going to be armed they may think twice about picking up the phone and making the call that saves their lives. It’s an interesting contradiction: arming EMTs to protect their lives may end up costing the public theirs.