A True Medical Alert

[swatsurgeon]

For those of us that work to save lives there is an inherent risk, especially in our world of Trauma. Patient and family satisfaction don't always add up to a positive number especially when we are held 'responsible' for a good outcome that may not happen. (can't make chicken soup out of chicken shit paradigm)

I have been stabbed in the leg, threatened that "if she dies doc, you die" (the brother of a patient driving drunk and hit a wall at 90mph and in coma), pushed around, punched and verbally abused. After the stabbing, I have been armed every day at work. Even in my neck of the woods, people come to our hospital with a grudge.

Be warned, be armed. The hospital police are for the most part out of shape, poor shots, never around and too far away. This is were I use my 'smart carry' holster, under scrubs or dress pants. Never un-armed in this environment and this article is one of many we read from around the country every week.

http://www.macon.com/220/story/306000.html

ss

[swatsurgeon]

3 years after I left the last hospital trauma center I ran...this happened:

Officer Killed in Hospital ShootingFriday, September 30, 2005 | 6:44 PMSuspect in Custody LANGHORNE, Pa. (AP) -Sept. 30, 2005 -- Two neighboring police departments pitched in to patrol the streets of tiny Newtown Borough on Friday, a day after a hospital shooting left one of the borough's four officers dead and another wounded.

Officer Brian Steven Gregg, 46, was killed Thursday night after he and officer James Joseph Warunek, 31, scuffled with a drunken-driving suspect they had taken to St. Mary Medical Center in Langhorne, Bucks County, for routine blood and urine tests.
Police said the suspect, Robert A. Flor, 38, grabbed Warunek's gun and fired five shots, killing Gregg and wounding Warunek.

And 1 year ago, one of the hospitals dealing with victims of the VA tech shooting had a prisoner steal a sheriffs gun and shot a hospital security guard .

Not a safe place to work......

[Surgicalcric]

DocT and I worked in a hospital in upstate SC where these were a near weekly ocurance. I cant recount the number of times someone made there way into the ER or the trauma bays carrying a firearm to finish off what they started, threaten the staff, or attempt to kill one or more of us for their loved one dying.

As you stated Sid, the security in hospitals for the most part was and still is useless. Its past time for us to become responsible for our own security instead of entrusting it to those who are no more capable than the average citizen.

Now if I could find a way to carry on the ambulance once I return home I would be in business...

Crip

[Team Sergeant]

I remember Doc T being in the hospital with a prisoner on the loose..... found him in the air duct if I remember correctly. Stupid bastard watched too many hollywood movies.
I also remember Doc T having to run through a hail of sniper bullets to just to get to work one day.....or was that someone else?;)

Hospital security is what you pay for.....I'll take the job, at $500 a day;)

[Razor]

SS, good job on recognizing a viable threat, and taking the steps necessary to be able to protect yourself instead of relying on others! The surgeon that tried to save the two girls killed in the New Life Church shooting came to the gun club of which I am a member a week after the shooting, bought a gun, and took the CCW course they offer. He said the incident made him realize how weak security can be (especially at his hospital), and wanted to be able to protect himself if need be.

[Surgicalcric]

I remember Doc T being in the hospital with a prisoner on the loose..... found him in the air duct if I remember correctly...

I was there that day. He had a .22 pistol as well that security missed when he was brought in. I am not sure if they ever figured out where he got the gun (family or it was stashed in the ceiling tiles).

We had many colorful evening in that ER...and quite a few in the parking lot and on the EMS ramp as well. I seem to remember a guy making his way just inside the trauma OR #17 one night as Dr A was working on a shooting victim. He ended up with a fractured R/U, nose, and a few lacs while being kindly escorted back out of the OR by a paramedic I know. :D He was transported to jail that night with a soft cast and several staples/stitches. The paramedic however was thanked by being asked to take several days off work to think about what he had done.

I hear it has gotten worse in the past couple years too.

Crip

[Monsoon65]

The paramedic however was thanked by being asked to take several days off work to think about what he had done.

Let me guess: Without pay, right???

Never been an ER doc/medic (tho I've been mistaken for Anthony Edwards several times), but I've been an ER patient a lot. Some of those places can be pretty interesting to say the least.

[Red Flag 1]

After all of that, you still had to deal with pathogens that you could not treat with antibiotics., etc., etc. There were times when I considered wearing chain mail and a body condom.

RF 1

[Dragbag036]

I by no means am the likes of you more educated medical professionals, but I do still try and keep up my skills. About 2 months ago here in Moore County, NC I was on a call that brought me to a rural area of Vass in which we were told it was a suicide attempt. On arrival at the scene we find out that the individual ran into the woods with a rifle and had a history of mental illness. Looking at the rather out of shape officers on scene I began to ask the family questions that obviously had been overlooked. First of all being a Paramedic, if the scene is not safe we were not suppose to be called in, but there we were. I asked the family if this gentleman was an avid hunter?, what type of rifle is it?, is the rifle scoped?, how long has he been gone from the house?, where is his usual layup when out hunting the family land?, and does he fill threatened around authority? Now being in the role of Paramedic, I began to get strange looks as these should have been law enforcement questions. We have had to detain, wrestle, threaten and even put a very large patient out of a moving ambulance all to cover for each other. The threat to medical providers is very real. I very much agree that one must exercise care when dealing with patients in various environments.

Psalms 59:2 "Deliver me from the workers of iniquity, and save me from bloody men".

[adal]

All of this is the reason I am looking into the purchase of IBA for my medics in the field. Small community, not a lot of violence, but the potential is always there. In the last week I can count four instances when my crews would have had to wear IBA for a stage for suicidal/combative patient and they would have been in the right.
Was at Ft Sam when a guy went into Beach Pavillion, onto the Surgical Intensive care ward to "finish off" a guy he had shot earlier. Thank God they had a panic lock down button that isolated the ward. MP's caught the guy in the parking lot after he couldn't get in.

[Team Sergeant]

I was there that day. He had a .22 pistol as well that security missed when he was brought in. I am not sure if they ever figured out where he got the gun (family or it was stashed in the ceiling tiles).

I hear it has gotten worse in the past couple years too.

Crip

It's gotten worse only because of the morons running that hospital.....

You should have been there the day "security" had Doc T's car towed for being parked in the "Law Enforcement Only" parking spot!:eek:

Head of hospital security was soon hiding in the same air duct
as the last bad guy.....;)

BTW Dr. A is doing well...;)

[Sdiver]

I agree 100%, about hospital security being lax. Of the 20 plus hospitals here in the Denver Metro area, I only know of 1 that has a full time armed LEO presence. All the others have that wonderful :rolleyes: HSS security, and only a few of those "officers" carry Tasers.


Guns v. Blades

Here's something that happened to me not too long ago. Got called to a Mental Health Facility downtown, for a kid off his meds, hearing voices and "seeing" things, on a M-1 hold needing to go to Denver General, to be medically cleared for placement.

We roll up and find the Pt. with the staff member already waiting for us outside. There is no PD on scene. My medic and I walk up and start to get the report. 18 y/o kid, homeless, Hx of Psych behavior and off his Meds for the past 3 weeks. Stated he's been hearing voices, telling him to hurt himself. The Pt. was cooperative and willing to go into DG.

So we walk over to the ambulance and before we get in, I ask if the Pt. if he has anything on him I need to know about, and if he could empty his pockets for me. The "staff" member comes up and says, he's already been searched. I look at her and tell her, "That I'd like to to it for myself.....I'm funny that way." I get a "Humph" from the staff member and ask the kid to pull his shirt out of his waist band, and to just turn around for me. Seeing nothing, I ask him to empty his pockets on the step into the rig.

He pulls out a wallet, some papers, a few other nick nack stuff, a cigarette lighter and 2 boxes of cigarettes. I pick one box up, shake it and hear a couple of cigarettes inside. Open it and confirm, that there are indeed 2 cigarettes in there. I pick up the 2nd box and shake it, feeling it somewhat full. I open it, and see that it's about 3/4 of the way full. But something inside caught my eye. There was a partially smoked cigarette in there, (you could tell by the yellow on the filter). Call it, my spidy senses started tingling, or I felt a disturbance in the force, but I pulled out that partially smoked cigarette and found, that this kid emptied the tobacco out of the cigarette, then had taken a wooden dowel rod, (the thickness of a cigarette) about 2 inches long, and had taken a razor blade off of, what looked like a disposable razor, and stuck one end of the razor, into one end of the dowel, and then placed it back into the emptied cigarette. He made himself a nice "slashing" weapon.

I looked over at the staff member, the one that told me he was searched, and just gave her a look of, "Riiiiiiight", while showing her this kids "weapon". I ask the Pt. if he has anything more on him I need to know about, and he tells me he doesn't.

We put his stuff in a plastic bag and get him loaded up and buckled in on our cot, and instead of sitting next to him on our "work bench", I take up a position directly behind him in our "Captain's chair", keeping an eye on him the whole way to the HSP.

We get to DG and walk into the ED, and are met by the HSS security people who announce either Medical or Psych, alerting either the charge nurse or the psych nurse. The HSS guy comes over and asks the Pt. if he has anything on him, keys, lighter, knives, ect., to which I hold up the plastic bag and show him what I found, but he my want to call up one of the S.O.'s from downstairs, or if there's a DPD officer available to come up and search this guy further. The HSS guy asks "Why?", and I tell him because I found a cleverly disguised blade on him, and I show him the "cigarette blade" I found. HSS guys eyes got as big as saucers, and he walks over to a phone and makes a call.

The Psych nurse arrives and I give her my hand off report and tell her about the blade I found, and that I already told the HSS guy to place a call, for one of the S.O.'s to come up. So we take the Pt. down to the Psych ED and put him in a room just as the S.O. gets there, and I show him the "Cigarette blade", and he concurs that a more detailed search is needed.

I walk out, and up to the front desk, to finish my report. I'm there for awhile and the S.O. that did the search, comes walking up to me and tells me, that he found another razor, an older style single blade razor, in it's protective cardboard, taped to the bottom of his foot. Not his shoe, but the sole of his foot.

Needless to say, I don't care if a staff member, family member, RN, Doc, or even PD says a Pt. I'm about to transport has been searched, I'm going to preform my own search. Like Reagan told Gorbachev........."Trust, But Verify."

[Surgicalcric]

It's gotten worse only because of the morons running that hospital.....

BTW Dr. A is doing well...;)

It was as bad as it was, at the time we worked there, because of the administration. I can only imagine now.

Thanks for the update on A. Does Doc T talk much with Dr Rick M?


Dragbag, I have had some of the same experiences working at the FD and at EMS. There were several of us who had enough forethought to purchase concealable armor circa '94. Many of my coworkers at EMS laughed at me sweating in it, until the first shooting incident claiming the career of one of my partners. It has saved my skin on a couple of occasions. The EMS service where I worked issues armor now in a bright blue outer carrier. They are nice but I still prefer my concealable carrier and will be purchasing a new one once I return from here.

Crip

[Patriot007]

SS,

Any off the record advice for the student/resident in the ED? Run fast???

As a side note- within the last few months our little on campus gun free housing next door to the ED long considered in a safe zone has had two break-ins when people where clearly home and nothing was stolen even with laptops sitting out. The first intruder tried to break down the occupied BEDROOM door of a student COUPLE, the other incident resulted in a female student being assaulted in her room.

I choose not to rely on security.

[Team Sergeant]

It was as bad as it was, at the time we worked there, because of the administration. I can only imagine now.
Thanks for the update on A. Does Doc T talk much with Dr Rick M?
Crip

We got the XMAS card from Doc M a few months ago! I'm not sure how much they talk now.

SS,

I choose not to rely on security.


As I said, you get what you pay for....;)

[cold1]

This is a very Eye opening thread.
The underlying theme here seems to be "Your safety is Your responsibility".
This is something that I have started to preach to our new guys on the Vol FD.

[swatsurgeon]

This is a very Eye opening thread.
The underlying theme here seems to be "Your safety is Your responsibility".
This is something that I have started to preach to our new guys on the Vol FD.


Very true....
I will utilize concepts that are near and dear to the QP's and others here: situational awareness is mandatory for health care providers. Whether it is on the street, in the E.D., the Trauma room or on the hospital floors.....SA can save your life.
Forget panic buttons...they are to alert the security staff to a clean up operation. Just look around your working environment and imagine what steps it would take to knock a few things off of the 'to do' list to make it safer. Are there locks on doors to isolate you from a threat? We NOW have them on the Trauma room. Is someone watching your six or are you alone and focused entirely on the patient, not on the crowd or 'friends/family'.....situational awareness will hopefully prevent an untoward event from initiating, IF you or someone can identify it before it happens.
How many of us work as a team.....not the 'care team' but as a 'tactical team'. Try it out, we are in our ED and Trauma area so that signals (verbal/other) are clear and understood and people know what to do rather than wonder what to do.....practice it and it improves for everyones safety.

ss

[Odd Job]

@ cold1

This is a very Eye opening thread.
The underlying theme here seems to be "Your safety is Your responsibility".
This is something that I have started to preach to our new guys on the Vol FD.

It seems to be a universal problem, but some places are hot spots for trouble. Some people have a false sense of security about being on hospital premises, which only disappears when they see their hospital security guards in action ;)

In Johannesburg we had a very good relationship with members of the Flying Squad, especially when some of our ER docs were threatened at gunpoint by patients and their relatives. Usually it was a case of a belligerent customer with a minor injury wanting to be seen immediately, even though the docs were tied up with several resus patients already. The nurses developed some delay tactics for that. Here's how one such event played out:

1) Dude comes into casualty with a gunshot foot, and demands to be seen immediately.
2) Triage nurse says 'Take a seat, we got three resuses going, the doctor will come out soon and see you.'
3) Dude screams abuse at the nurse, saying he wants to be seen right f**ken now. She tells him again, he can't be seen right away because the patients that are being treated are at death's door and must take priority over Dude.
4) Dude isn't happy, continues swearing, starts yelling for a doctor.
5) One of the docs comes out of the resus bay and shouts to Dude to shut up and sit down.
6) Dude pulls a pistol, aims it at doc's head, and says 'You leave what ever you're doing and come fix my foot right f**ken now!'
7) Doc says 'Okay, have a seat in this cubicle, take off your shoe and sock and the nurse will get the dressing pack and I'll get the X-ray machine. Sorry for the delay. Just give him some privacy, nurse, close the curtain there.'
8) A few minutes later one of the flying squad guys bursts through the curtain and Dude catches a few righteous slaps, his pistol is taken and he ends up pinned on the floor. After a reprimand he gets a seat in the waiting area...the same seat he was originally assigned by the nurse :)

We've had some bad times in Johannesburg, but nothing that would surprise any of the regulars here. There have been deaths (patients and staff).
I do find two things interesting though:

1) A staff member (particularly one who does not have any experience with firearms) can actually precipitate an untoward event involving an armed patient. Unfortunately (in South Africa at least) you can bank on a distinct minority of staff having any experience with firearms, much less owning one. There is a general dislike of firearms amongst the staff members, many of whom view the firearm itself as the source of their increased workload in general. It is hard going if you pick an argument with one of those people. I think you can minimise problems between armed patients and radiographers for example by having some guidelines for them (you can PM me if you want to see the ones I have written). Much of it depends on the demeanour and delay tactics of the staff member involved, but generally the hospital security is a waste of time at best and an inflammatory agent at worst. These patients don't have to start out belligerent, but they can get that way if the staff member makes a big issue of the patient's weapon for whatever reason.

2) Trouble can happen anywhere. At the UK hospital where I am currently working (in quite a nice part of north London), there was a drive by shooting and two people standing outside the A&E department were hit. I heard the shots and saw the shooters ride away on a motorcycle. I ended up calling that one in, protecting evidence on the ground (9mmP cartridge cases) and making sure the clothes of the victims weren't misplaced in the resus bay. That could have been me getting shot if I had been coming out of the front entrance of the hospital just 20 seconds earlier. One of the victims was an unintended target.
At the same hospital, more than 10 years ago, an adult male patient who was using a telephone outside the ward was shot in the back of the head with a small calibre weapon. He was found collapsed on the floor and the nature of the bleeding at the back of his head was not immediately apparent. The guy was in hospital for a haemorrhoid op. He didn't make it.

So I don't take anything for granted. I would very much like to be armed at all times, as I was in South Africa, but you know the deal about the UK...
At least in South Africa I carried wherever I went, and although I would never make any claims about my proficiency with a handgun on a site like this, there were many times where I accompanied someone to their car because they were unarmed and somebody had been verbally abusing them or making threats.
Rather have it and not need it, and all that...