It's no secret that a tremendous amount of pre-hospital medical care is being provided by fire departments. Many EMS calls involve acts of violence such as assaults, stabbings and shootings that occur in incidents ranging from gang fighting to domestic disputes.
Emergency responders are finding themselves performing their duties in a much more dangerous setting on a more frequent basis than ever before. For example:
- An engine company in New York City was firebombed while investigating a gas leak.
- Fire companies operating during riots in Los Angeles were forced from structure fires, attacked with axes and shot.
- Washington, DC, firefighters aboard an ambulance were shot at while treating the victim of a shooting. One firefighter was injured.
Although these incidents occur-red in major metropolitan areas, they could have happened to firefighters anywhere at any time.
Photo by Glen E. Ellman
Firefighters and police transport victims from the scene of a multiple shooting at an apartment complex in Fort Worth, TX.
As our society changes, firefighters are forced into a new role. To many in the community we are just there to help. To others, however, we are part of a system that threatens them. Any time we respond to an incident, there is potential for us to be caught in the crossfire.
There are steps you can take before you respond to one of those dangerous situations. Develop standard operating procedures (SOPs) that address everything from information that needs to be obtained from callers to apparatus placement and use of bulletproof vests.
Re-evaluate uniforms. During a uniform up-grade to meet National Fire Protection Association (NFPA) standards for stationwear, one municipality found that police officers and firefighters were almost identical. Their uniforms were so alike that people were commonly asking firefighters to assist with police matters. In one incident, a burglar caught breaching the wall of an office next door to a fire station surrendered to a firefighter, believing him to be a police officer.
If your stationwear resembles the uniform of your local law enforcement agency, consider making some changes. Letting fire crews wear T-shirts with the department's name on the back in large letters, reflective vests or lightweight flame-retardant jackets like those worn in wildland firefighting will help to distinguish you from other agencies when responding to incidents with the potential for violence.
Anything members of a fire company can do to identify themselves as firefighters should help. Announcing that you are from the fire department or wearing your firefighting helmet will help people identify you. Never assume people know who you are.
Another area of concern is apparatus. The use of enclosed cabs has made fire crews much safer from bystanders throwing items at rigs. During the Los Angeles riots in 1992, the city fire department moved chief officers out of their sedans and into utility vehicles for added safety.
When dispatchers take information on a violent incident, they must ascertain what type of incident it is (assault, stabbing, shooting, etc.), the number of patients involved and, most important, whether the person or persons who committed the act are still on the scene.
Fire and police dispatchers must be in contact with one another so that new information can be provided to responding units. Fire companies should have information on police response times a fire company does not want to be first in at a gun battle in progress. In many metropolitan areas response times for police may be much longer than firefighters and EMS personnel are accustomed to. Some incidents may need to be secured by law enforcement before any patient assessment can begin.
Photo by Glen E. Ellman
Emergency responders are finding themselves performing their duties in a much more dangerous setting on a more frequent basis than ever before.
If you have information that the perpetrator is still on the scene and the police have not arrived, firefighters may choose to stage out of the area. This may be a difficult choice for officers but the safety of their crews is their first concern.
If staging is your choice, be sure to stage well out of sight of the incident. Bystanders who can see you stage down the street may believe that you are not willing to perform your duties and they could become angry. Staged companies have been confronted by bystanders and forced to go into an incident without police support. The police must be aware of your staging SOPs so fire companies can be notified when the scene is safe and they can move in.
One of the tactics most commonly used by gangs is the drive-by shooting. For example, Fort Worth, TX, with a population of 453,000, experienced 268 drive by shootings in 1994. The fire department responded to most of those incidents.
The most common targets of drive-by shootings are cars filled with people, occupied homes or crowds of people on the street. The perpetrator will drive-by and fire as many shots as possible, often injuring or killing several people.
When responding to a drive-by shooting, expect three things: the possibility of multiple victims; large groups of bystanders; and a very emotional crowd. The combination of these factors will produce a dangerous and explosive incident. A strategy the Fort Worth Fire Department found effective is to dispatch two fire companies to this type of incident. This lets crews work quickly to treat, package and load patients for transport. Company members not involved in patient care can help to control bystanders in non-threatening ways such as using barricade tape or a rope bag to quickly form a barrier between the patient area and the crowd.
Another advantage of the two-company response is that it lets apparatus block both ends of the street. This prevents bystanders from driving past the incident and can keep perpetrators from returning to harm more people.
A fire officer responding to a violent incident must develop an incident size-up just as at a structure fire but predicting human, not fire, behavior. When assessing a scene, be sure the area is secure. Police should have completed this task but check until you are clear of the incident.
Firefighters and police officers must be aware of each other's action plans. If you are not comfortable with scene security, meet with the ranking law enforcement officer on the scene and make the appropriate corrections.
As a fire officer, you must continually re-evaluate the scene. Condi-tions can change rapidly and you need to react early to those changing conditions. If at any time you feel your crew's safety is in jeopardy or at risk, you may need to withdraw to a safer area until the police can secure it. When serving as the incident commander, don't get involved in patient care. It your responsibility to monitor the situation. Paramedics and EMTs may need to be reminded that the surroundings are hostile and that the safest place to provide patient care is in the ambulance, not in front of a crowd of emotional bystanders.
There has been much debate about the use of body armor by the fire service. The military and police have been using body armor for many years with great success, and its use is growing in the EMS community. There are times and places that the use of body armor by fire companies responding to violent high risk incidents would improve safety. It was not too long ago that wearing airpacks at structure fires and rubber gloves at EMS incidents were the exceptions rather than the norm; our next step may be the use of body armor.
Some people in the fire service would say a fire company should never be put in a situation that may require body armor. We should remember, however, that body armor is just another piece of safety equipment. Sometime in the near future we may hear that body armor has saved a firefighters' life.
In 1992, the Fort Worth Fire Department issued body armor to each riding position of its apparatus. This lets members don the body armor while enroute to a potentially dangerous incident. While operating at an incident at which body armor is needed, members should wear some type of garment over the armor to avoid drawing attention to their added protection. If body armor is to be kept on apparatus it needs to be stored out of sight of bystanders or in a secure area.
The fire service has recognized that society is changing and that fire departments must be proactive in their approach to service delivery. We can do this by developing guidelines for dealing with violent incidents and providing the necessary training and equipment to firefighters.
Homer Robertson is a lieutenant in the Fort Worth, TX, Fire Department and chief of the Granbury, TX, Volunteer Fire Department. He holds a master's degree in political science.