Is it safe?

Similar to the transportation is killing us post, is it safe is also a question that should be asked. Recent events make us consider safety and how do we deal with it. My experience is most of us deal with it badly; a fair amount of the poor dealing with safety is systematic problems that put us in harms way. The most recent multiple shooting incidents in Winnipeg and Toronto are great examples - Winnipeg had 6 shot (3 dead) and Toronto had 6 shot (1 dead). There are huge challenges in scenes like these and personal security is one of the biggest.

Think about it, entering a scene where there is a large police presence due to a shooting. You have waited done the street for a bit but now are being waved in by police. Arrive at the front door and simply have police officers pointing toward the house as they are trying to ascertain the situation outside. Going inside, there are multiple police officers assessing the situation with some providing CPR or other assistance to the injured until you arrive. As you are now trying to ascertain what other resources you need, police keep bring more injured to you or try to get you to go help another one. It is important that while the police have assured your safety, the situation could change in a heartbeat - deteriorating to where police may have to draw/fire their weapons (don't forget that if there are 24 police officers with you, there are at least 24 guns in the home).

You are not entering a "controlled environment" that most other health care providers enjoy. These types of situations leads to safety questions - where is the shooter (hopefully police do), unpredictable patients (are they the aggressors or the victims), is the patient carrying a concealed weapon, are there infectious disease concerns (hepatitis, etc)? Meanwhile, the training you recieved is shouting in your mind; be quick to keep your scene time down as patients need surgical intervention (the platinum 10 minutes of the golden hour). That is a lot to think about in addition to your treatment options and protocols. Add which hospital are you transporting to and all of a sudden personal security starts having to fight with other objectives.

Safety is our first consideration but it also needs to be an ongoing concern. There have been incidents where the Paramedics and Police were surprised by a shooter in a home (i.e. Steinbach, Manitoba). Transportation is our biggest killer but as the world is becoming more violent and the shootings aren't only in big U.S. cities anymore, we need to re-evaluate our security issues in order to protect ourselves. Some services in Canada (urban and rural) provide ballistic protection (vests) to Paramedics. Some provide self defense courses. What ever the reviews bring, we need to ensure everyone makes it home at the end of the shift.