Some years ago, a TV commercial showed a senior citizen by the name of Mrs. Fletcher lying on the floor, next to her walker, yelling, "I've fallen...and I can't get up." The commercial, which first ran in 1987, went on to describe a new technology involving a medical panic alarm that a person would wear and that when activated would summon help. That was many years ago and medical-alarm companies have proliferated. Just do a Google search and you will find many companies that provide medical alarms.
As the number of these companies continues to grow, fire departments find themselves responding to more and more medical alarms. The challenge to those fire departments involves the issues that confront them when they arrive on the scene. Those challenges are many!
Although the following call was not activated by a medical alarm, it easily could have been the source. In early September 2008, a Washington, DC, firefighter was shot after his company forced entry into an apartment. Firefighters went to a residence after a brother of the possible patient became concerned when he could not reach him on the phone. After firefighters knocked on the door and when no one answered, they forced entry into the apartment. The 57-year-old man in the apartment thought someone was breaking in and shot at the firefighters. Firefighter Hakim Carroll was grazed in the arm by a bullet.
Several years ago, a firefighter/paramedic in Ocala, FL, was crawling through a bathroom window of what he thought was the apartment of a person having a medical problem and could not answer the door. Unfortunately, he was crawling through the bathroom window of an adjacent apartment. An elderly man in the apartment thought the firefighter was an intruder and shot him in the chest.
Although I am not aware of a firefighter getting killed forcing entry into a home where someone may be sick or injured, the increase of more medical alarms calls received by fire departments, the opportunities and chances will continue to rise. The question fire departments must answer is this: Do we force entry into residences when a medical alarm is received?
Complicating the problem, some medical-alarm companies not only offer the panic alarms that you wear on your body, but the alarm company calls the residence once a day, or several times a day, to check on the person. If the person called does not answer the phone, the medical-alarm company calls the local fire department to check the property (the alarm companies usually are located out of state).
Unfortunately, in many of these cases, the person who the medical-alarm company is calling to check on has left the premises on vacation or is out shopping and did not notify the alarm company. The result is a dispatching of fire companies that must then decide whether to force entry. If they force entry and no one is home, the property owner is usually upset because the property has been damaged. In some rare cases, I have even heard of homes being burglarized after the fire department forced entry, found no one home and then left. In many cases, the property owners want the fire department to pay for damage to the property or for whatever may have been stolen.
The risk to the firefighters breaking a window or a door is that a resident may be inside, but did not hear the doorbell or the initial knock, and thinks someone is breaking in. Hopefully, that resident is not armed with a gun or another weapon.
Other complications may occur. Suppose that while a fire company dispatched to a medical alarm is assessing the property, police officers arrive and indicate they have received a call for a burglar alarm. What would have happened if it was actually a burglary and firefighters encountered a burglar?
Some fire departments have policies that members must force entry on every medical alarm if no one answers the door. Of course, it stands to reason that if a medical alarm was received, someone may be inside, unable to answer the door. Other fire departments let company officers make a decision based on an assessment as to whether to force entry. As an example, if neighbors tell the fire company that they know the person is away on vacation, the company officer would probably choose not to force entry. The company officer may also decide to do a good 360-degree of the residence, looking in the windows; knocking on windows and doors; listening for someone calling out for help or even trying doors to see if they are unlocked.
Some fire departments have gone to the other end of the spectrum and choose not to respond on medical alarms unless it is confirmed through an actual activation that someone is inside. Several years ago, Las Vegas Fire Rescue made it a policy not to respond to automatic fire alarms or medical alarms after fire companies reported an overwhelmingly number of these responses are usually false and did not require any service provided by the fire department.
There is no clear-cut answer to the explosion of medical-alarm companies and the medical alarms that fire departments receive. One solution is to provide firefighters with specific policies that can give them guidance on what to do when responding on medical alarms.
GARY LUDWIG, MS, EMT-P, a Firehouse® contributing editor, is a deputy fire chief with the Memphis, TN, Fire Department. He has 30 years of fire-rescue service experience. Ludwig is chairman of the EMS Section for the International Association of Fire Chiefs (IAFC), has a master's degree in business and management, and is a licensed paramedic. He is a frequent speaker at EMS and fire conferences nationally and internationally, and can be reached through his website at www.garyludwig.com.
