Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Tubes and Guns and Training, Oh No – Part II

 

EMS concealed carry of firearms has become a topic of discussion, again.[1]

One of the comparisons made was that firearms are like condoms. I don’t think that person understands the proper use of a condom.

A condoms is an effective tool for problems that might arise from something that is pretty common (sexual activity). There is no judgment about how to use the condom, while how to use a firearm during an EMS call is the most important part of carrying a weapon on the job in EMS.

Weapons are not effective tools for EMS to use, since too few of us seem to be capable of providing competent basic EMS care.

The most important weapon we have is our judgement. We regularly demonstrate that we do not have good judgment.
 

One example is needle decompression, which is used appropriately much more often than any weapon would be (if the weapon were used appropriately).

However, when needle decompression is used, the use appears to be almost always inappropriate.

Needle decompression does save lives when used appropriately.
 


Click on the image to make it larger.[2]

The chart is for all patients treated with needle decompression for suspected tension pneumothorax.

Many patients never had any kind of pneumothorax.

Was needle decompression used appropriately on any of these patients?

We do not know.
 

It is the responsibility of the EMT to make sure that his shooting skills – and decisions – are up to par better than par. Right?

Is it the responsibility of the EMT to make sure that his intubation skills are better than par?

No. It is the responsibility of everyone – the medical director, the employer, the supervisors, and the EMT. The life threatening skills we use on the job (intubation, needle decompression, cricothyrotomy, . . . ) affect much more than the individual, the individual’s reputation, and the individual’s income.

When I am at work, my First Amendment rights are limited.
 

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.[3]

 

The rights described above do change at work. The same is true for many of our other rights.
 

Tell your employer that you wish to participate in a public assembly on the job in uniform.

Tell your employer your unsolicited opinion of exactly what you think of the way things are run.

Tell your employer that you will share this unsolicited opinion with the press.
 

Our rights as citizens and our rights as employees are not the same.

This is not about protecting the Second Amendment.

Footnotes:

[1] Facebook discussion
Chance Gearheart
Facebook
Web page

After reading some of the EMS Forums and groups, I can safely say that I want to be nowhere near some of these people if they’re allowed to carry a handgun on the unit. They’ll be more of a danger to themselves than anyone else around them.

Barney Fife with a bullet in their pocket. Christ man.

[2] Inadequate needle thoracostomy rate in the prehospital setting for presumed pneumothorax: an ultrasound study.
Blaivas M.
J Ultrasound Med. 2010 Sep;29(9):1285-9.
PMID: 20733183 [PubMed – in process]

Free Full Text from J Ultrasound Med.
 

When Should EMS Use Needle Decompression
Rogue Medic
Thu, 10 Nov 2011
Article
 

Inadequate needle thoracostomy rate in the prehospital setting for presumed pneumothorax: an ultrasound study – Full paper
Rogue Medic
Mon, 14 Feb 2011
Article
 

Inadequate needle thoracostomy rate in the prehospital setting for presumed pneumothorax: an ultrasound study – abstract
Rogue Medic
Tue, 07 Sep 2010
Article

[3] Bill of Rights to the US Constitution
National Archives
Web site.

.

Comments

  1. I am proponent of concealed carry. There is no place at this time for EMS personnel to be carrying a firearm on duty unless they are assigned at that time to a Tactical Emergency Response team. Otherwise carrying a pistol leads to the medics entering situations they shouldn’t and escalating the situation just by their appearance.

  2. This is good.

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