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Back in the 1970s, as paramedics were emerging as definitive caregivers on emergency scenes, they were treated as heroes and rarely encountered any violence being directed toward them. But in the 1980s, more and more reported cases of violence against firefighters and paramedics began surfacing. During that decade, police departments started moving toward the wearing of body armor, but fire departments did little to protect their personnel.
In the middle and late 1980s, however, fire departments began changing their policies and had fire apparatus stage in a safe place on any violent crime scene. The purpose of the staging policy was to allow law enforcement to arrive on the scene first and secure it. Some fire departments even issued body armor to their personnel and required them to wear it on any violent crime scene.
Three recent events, starting in February and occurring within weeks of each other across the country, underscore why fire departments need to put policies and procedures in place to protect the safety and well-being of firefighters and paramedics.
In the first event, on Feb. 13, Lieutenant Brenda Cowan, a paramedic/ firefighter with the Lexington, KY, Fire Department, was shot and killed during a response to a shooting scene. Cowan’s promotion was just celebrated at the Fire Training Center on Feb. 10, and this was her first duty day following the ceremony. Another paramedic/ firefighter, Jim Sandford, was shot in the head, but survived.
The call unfolded when the Lexington Fire Department received a report of a woman shot. Unfortunately, the department had no policy of staging personnel and apparatus. Instead, Lexington fire personnel were trained to assist patients if the scene appeared safe. Cowan and Sandford arrived before police and felt the scene was safe. Regrettably, a dispatcher’s warning came too late for Cowan and Sandford. A dispatcher tried to warn the crew that shots were being fired at the scene. The radio transmission came just after they arrived on the scene.
When the paramedics approached the house, they came under heavy fire from a man who had just shot his wife. Eventually, the shooter gave up after a 51¼2-hour standoff with police and has been charged with the murders of Cowan and his wife and attempted murder for shooting Sandford.
Ten days later, a sniper shot at firefighters and MAST (Metropolitan Ambulance Service Trust) EMS personnel in Kansas City, MO, while they were responding to a house fire. In that incident, a paramedic from MAST was shot and had to be rescued by firefighters in the midst of gunfire. Doctors later indicated that if the paramedic had not been rescued and transported immediately, she would have ultimately died from her severe injuries.
In a third incident, on March 2, paramedic/firefighters from Las Vegas Fire & Rescue were treating a patient from a single-car accident when the man reached under the dashboard, pulled out a .45-caliber handgun and fired a single shot. The firefighters wrestled the gun away from the man and threw it outside, where it was retrieved by police officers. At first, the firefighters thought the vehicle’s airbag device might have gone off, but they soon discovered the patient had a handgun. In this case, no fire or EMS personnel were injured.
These three events within weeks of each other put renewed emphasis on the need for fire departments to develop policies and procedures to protect the health, safety and well-being of their employees on violent crime scenes. At a minimum, fire personnel should be staging at a safe distance and allow law enforcement to secure the scene.
Fire departments should have policies and procedures for dealing with violent crime scenes. Typically, fire departments upon receipt of call that could potentially involve violence, such as a shooting, stabbing or any other form of assault, should direct responding crews to a staging area. The staging area should be several blocks away and out of sight from the incident scene.
Some fire departments have their fire crews stage on the corner of the incident. The only problem is that the ambulance or fire engine may be visible from the incident scene and irate family members or bystanders will want to know why help is sitting on the corner while someone needs medical attention. It can be a precarious situation for fire personnel when they finally do get to the scene. Therefore, as a safe rule of thumb, any staging policy should have the staging area away and not visible from the incident. Some fire departments let the company officer pick a staging area, since a dispatcher designating a staging area may actually have apparatus drive through the scene in order to reach the staging area.
Another important component of any staging policy is making sure the scene has been secured by law enforcement prior to entry by fire personnel. The operative word here is “secure.” A staging policy should not indicate that it is acceptable for fire personnel to enter a crime scene if the police are “on the scene.” There is a difference between police “on a scene” and “securing a scene.” When a scene is secured, it means law enforcement has determined that the assailant is no longer on the scene or has been taken into custody.
Some fire departments provide body armor to personnel. If body armor is provided to fire personnel, the policy should indicate that firefighters and paramedics should don their body armor prior to entering the crime scene.
Another essential element of any staging policy or procedure is a method of communicating with the police. Once the scene has been secured, there should no delay in moving fire personnel and equipment into the scene. Any further delay could be detrimental to a patient’s condition. Many fire departments have placed police radio channels into existing radios to facilitate better communication between law enforcement and fire personnel.
In some communities where police, fire and EMS dispatchers all work in the same communications center, easy verbal exchanges among the dispatchers can help determine when a scene has been secured so fire personnel can move in. In the Kansas City and Las Vegas incidents, there were no warnings of violence, but certainly the nature of the call in Kentucky pointed to increased risk and potential danger to fire personnel.
Unfortunately, it usually takes a tragedy such as the death of Lieutenant Cowan in Lexington to change policy. Within days, the Owensboro, KY, Fire Department has changed its policy to require fire equipment and personnel to stage and wait for law enforcement to secure the scene. Any fire department that does not have a staging policy for violent scenes should enact one.
Gary Ludwig will present “Does Your EMS Chief Know About This?” and “Preparing for Suicide Belt Bombers” at Firehouse Expo 2004 in Baltimore, July 13-18.
Gary Ludwig, MS, EMT-P, a Firehouse® contributing editor, is the chief of Special Operations for Jefferson County, MO. He retired in 2001 as the chief paramedic for the St. Louis Fire Department after serving the City of St. Louis for 25 years. He is also vice chairman of the EMS Section of the International Association of Fire Chiefs (IAFC). He is a frequent speaker at EMS and fire conferences nationally and internationally, and is on the faculty of three colleges. Ludwig has a master’s degree in management and business and a bachelor’s degree in business administration, and is a licensed paramedic. He also operates The Ludwig Group, a professional consulting firm. He can be reached at 636 789-5660 or via www.garyludwig.com.