All I got was a "You are not logged in. " message......

Pistol Packin’ Patients


You are dispatched to an unconscious male at the park. Upon arrival you find an adult male unconscious, with classical signs of anaphylaxis. After initiating treatment, you place the patient in your ambulance, and begin transport. As the patient begins to respond to treatment, your student performs a physical exam. “Hey, this dude’s got a gun!”

Virginians have been able to carry concealed handguns as a shall-issue state since 1996, and for much longer as a may-issue state prior to that. Virginia has concealed handgun agreements with at least 21 other states. Open carry of handguns is legal throughout Virginia, and 47 states have some form of process for legal concealed carry. Nebraska recently enacted legislation that requires permit holders to disclose and surrender their handguns to emergency service workers. Virginia, however, has no such allowance.

It is possible that EMS providers will come into contact with a patient who is carrying a handgun. Awareness of a handgun may be by the patient’s admission, or be discovered during the physical exam. The mere presence of a legally carried handgun should not indicate a thread to EMS safety. Illegally carried handguns may present a different set of concerns. Providers have a duty to themselves and their coworkers, to make any such handguns safe until they can be secured, or turned over to a law enforcement officer. An officer may not always be immediately available. EMS agencies should have in place a protocol for how to deal with legally carried firearms that are not subject to law enforcement action.

While many EMS providers may be reluctant to take custody of a handgun, there may be no other option. The patient may have an altered level of consciousness, be physically impaired by injury, the handgun may impede application of a backboard, or narcotic treatment may be indicated. There is no cause for alarm. Handguns do not go off by themselves. A handgun will only discharge if the trigger is depressed, or if there is a mechanical malfunction, which is quite rare.

The three rules of EMS gun safety. 1. All guns are always loaded. 2. Never point the gun at something you are not willing to destroy. 3. Keep your finger and other objects off the trigger at all times. Nobody will be injured by a gun unless multiple rules are disregarded. The primary safety device for all guns lies between the ears.

You may find a holstered handgun at any point along the belt, in an elastic band or pouch under the pants, under the armpit, on the ankle or thigh, hanging from a necklace, or in a pants or coat pocket. Several manufacturers offer specialty concealment apparel with hidden pockets. Other off-body carry options include purses, fanny packs, day planners, and backpacks. Virtually all holsters are designed to prevent inadvertent trigger presses by covering the trigger. Some holsters have retention devices that prevent the handgun from easily being dislodged or removed. These include buttons, straps, and friction fit. Some holsters are secured to the body by a belt loop, while others slip over the belt by means of tabs, springs, or clips. The vast majority of handguns can be rendered safe by simply leaving them in the holster.

The revolver is rarely seen with a manual safety device. Safety is assumed due to a heavy trigger pull. While some may be modified for a light pull, this only applies if the revolver is cocked. Cocking a revolver rotates a cartridge under the hammer. Pulling the trigger causes the cartridge to fire. Most modern revolvers will cock first in sequence while pulling the trigger, eliminating the need for two separate actions. To unload a revolver, press the cylinder latch (behind the cylinder on the left side) forward, back, or in, depending on the model, push the cylinder open, and allow the cartridges to drop free.

The semi-automatic pistol is loaded by inserting a magazine, then manually cycling the slide. Pulling the trigger causes another cartridge to enter the chamber, making it ready to fire again by another pull of the trigger. The pistol may or may not have a manual safety, which, if available, is usually located on the upper left side at the rear. Generally, up means safe, down means fire. Some may have a de-cock feature, which requires a downward press. Many pistols have no external hammer. Some are designed to be carried “cocked and locked,” that is, cocked with the safety engaged. The variations of pistols available on the market, and subsequently the steps required to unload them, cannot be adequately addressed without hands on instruction. The pistol owner’s instructions, or a working knowledge of pistols, are strongly suggested prior to removing the cartridges. The rest of this paragraph is meant only as an adjunct to hands-on instruction. The magazine release is usually located at the rear of the trigger guard, on the left side. Removing the magazine DOES NOT remove the cartridge already loaded into the chamber. The slide must be cycled to remove this cartridge, and will usually lock in the open position, as long as the magazine is out. The safety may have to be disengaged to cycle the slide. Failure to remove the magazine prior to cycling the slide will only cycle another round into the chamber!

EMS providers are encouraged to seek professional instruction prior to attempting to manipulate any handgun. There are a number of gun shops and trainers in the area, which may be willing to offer a brief tutorial.

So back to the matter at hand, what to do with the handgun? A soft or hard sided pistol case is optimal, and can be found at prices starting between $6.00 and $21.00. They can then be padlocked (keep the key on the ignition ring). Handguns are expensive high-theft items. If possible, secure the case in a locking cabinet. Upon arrival at the hospital, have security take control of the handgun, and get a receipt. Make sure the patient is made aware of the disposition of his property. Some patients may be reluctant to surrender their handgun. This may be for safety reasons, as they do not want anyone handling their handgun, or the chance that it may get in the wrong hands. These concerns are understandable. Can the handgun be turned over to a relative, left in the home, locked in the trunk of a car, unloaded prior to transport? If not, a police officer may have to be requested.

EMS safety is paramount. Last year, a provider in North Carolina was helping an intoxicated patient off the stretcher when he pulled a handgun and fired into her chest. She survived. The patient was wrestled to the ground by firefighters. Elsewhere, an EMS crew was killed by an angry spouse upon returning to their station. Separate incidents have been reported of EMS crews being targeted by deranged homeowners. Reports out of the United Kingdom show that violence against EMS is rampant. There are techniques that can be employed, to prevent injury during an assault. We in EMS should not assume we are immune from violence. Often the first sign of violence comes after our arrival. We should expand scene safety to include self defense.
__________________
Alan W. Rose
Guns Save Lives. Paramedics Save Lives. But...
Paramedics With Guns Scare People!

The Trooper said, "Do you have a gun?", and I said yes. "Is it loaded?" and I nodded and said "2 spare mags". He then said, "I'll need to take that from you.". Still laying on the ground, I said, "I've been here for almost a half hour, and it hasn't been a problem yet. Is that really necessary?", and he said that he would get back to me. He never mentioned it again.

I think they also need to pass a class just to drive the ambulance.

They do