Addressing the Security of Pre-Hospital Care Providers

EMS and Paramedics Carry Guns on the Job

Emergency Medical Services (EMS) are a form of emergency service, whose main objective is to provide acute medical care, transportation to healthcare organizations, including special medical transport to patients of attacks due to act of terror and others of the same kind. In addition, the emergency medical services are also locally referred to as paramedic service. Other countries across the globe refer them as first aid squad, emergency squad, rescue squad, or ambulance squad. Their services mainly include the transportation of patients to other definitive points of care for them to receive urgent care. They also engage in a timely removal of patients who require the urgent medical intervention to other points of care. The job description of these personnel comes with substantial risks.

This is because the personnel put their lives at risk more than the common citizens (Grady and Revkin). Notably, there is no mechanism in place, which aims at protecting the lives of these personnel. The emergency vehicles used by the emergency people have stern rules against carrying weapons, when the staff is on duty. This includes weapons such as guns, knives and others. Although the EMS and paramedics do not qualify as police, they actually engage in similar activities as the law enforces, this ranges from activities pertaining to drug overdoses, assaults, homicides, and suicide.

Therefore, their job requires them to handle or find themselves in trouble on a daily routine. Literature reports that the only mechanism in place for their protection is a dispatcher who makes the decision on whether the scene is safe for the EMS personnel to go for a rescue or any other relevant activity. The next line of protection for their protection is radio calls, and lastly, what appears to be more of a joke, is their ability to run away when they face hostility (Boyle 760-763). Therefore, this has raised debates on the issue of safety, particularly for the EMS and paramedics.

This has been received with tension, and there has been a suggestion to allow the personnel to carry concealed weapons to protect themselves because the cases of assault on them have been high. On the other hand, constitutions across the world differ a great deal. In the case of United States of America, the constitution allows citizens the right to keep arms; therefore, should the employers behind EMS and paramedics allow them to have guns when they are on duty? Apparently, the emergency personnel are to deal with violent issues, some of which police cannot handle, but owing to the use of guns, and the fear of guns, police can handle them, as well.

Emergency services respond to weird situations, and although they often reach the scene at a good time, they are shocked because some of the victims turn unto them. Therefore, they end up being the victims after their efforts to help (Bigham). Some of the posted experiences on the internet about their assaults by victims are too many, which calls for urgent intervention if the emergency department or service is to continue. Governments across the world have reasoned out differently on the issue.

In the United States, for example, some states have legalized the use of guns by the emergency personnel. However, others feel that guns will pose potential fear to victims, which will influence the services. In addition, there is a fear that the emergency personnel are not in a position to determine when to use a gun, and may cause deaths or may act by shooting inappropriately. Therefore, there is a need for the staff to receive education on how to use guns (Frolic).

Evidence of Violence

In the year 2002, there were substantial studies, which aimed to examine the prevalence of violence against the emergency personnel. Apparently, the studies showed that the paramedics were exposed to violent behavior in their course of duty (Boyle 760-763). Most of the studies concentrated on the emergency personnel in healthcare organizations. One study took place in Southern California Metropolitan area. The consecutive calls in the organization were analyzed for a month, and during the time, the pre-hospital staff recorded any information concerning violence both physical and verbal during routine provision of care, including the issues that may have resulted or instigated the behaviors.

There were 4,102 cases for evaluation. The results show that there was violence in 8.5% of the patient encounters. Of the reported violence, 52.7% was directed to the emergency personnel. On the other hand, the incidence of the violence was 4.5%, and the type of violence varied, with the highest percentage being physical and could endanger the life of the personnel. Therefore, the results provide empirical evidence that emergency medical services provider in some states of the United States are at higher risks of encountering violence in their routine duty. The suggestion from the study is that the personnel should be provided with protective gear to enhance their protection when in their line of duty (Grange & Corbett 186-190).

In Australia, literature suggests that violent and aggressive behavior is a common phenomenon across the emergency personnel. The personnel describe the issue as "part of the job" and they see it as acceptable rather than an issue, which requires assessment and management in their daily provision of emergency services. Some recent studies in the same country suggest that the occupations homicides as 2-3% of all the traumatic workplace deaths, 24% of the deaths happened in the field. Similar studies in Australia, UK and USA comment that occupations with the many face-to-face contact are vulnerable of violence initiated by the clients.

However, in comparison to men workers and women workers, the studies show that women experience higher levels of verbal and sexual abuse, whereas the men experience more threats and physical assaults, which endanger their lives (Mechem 401). In other studies of emergency service workers, in the U.S.A., 61% of the assaulted emergency workers were in the field, and 25% of the assaulted workers were forced to seek medical attention due to the violence. In a Swedish study, the result show that 80.3% of the emergency paramedics had received threats or were subject to violence, 67% encountered physical violence and over a third of the workers had received threats of violence every three months, from a patient, relative, or friend of the patient.

In another study, 98.1% of the paramedics felt that the violence resulted to altered relationships with families of the patients (Seserund, Blomquist and Johansson 135). In the year 2011, there were 2,977 people killed during the September 11 attack. Among the killed people, 441 of them were emergency workers from New York who had responded to the attacks. There were 341 firefighters and 2 paramedics from the fire departments of New York, 60 police officers from the police department and 8 emergency staff. Therefore, this shows that the emergency staff risks their lives, or work in almost similar situations as the police officers, and other professions in the same line.

Critics against Guns for Paramedics

Although the issue of emergency personnel being supplied with protection and guns top the list, there are people who perceive the idea as being terrible, and which will result to adverse effects on the provision of emergency services. In this regard, critics feel that the constitution has right to protect their lives and to grant them guns is one of them. However, issuing those guns without prior training on how to use them will only result to substantial deaths. It takes a lot of training, experience, and practice to become an exceptional gun user.

In this regard, they compare them with the military, police, and other armed professionals who receive appropriate and adequate training prior to receiving guns. On the other hand, EMS is a professional that cannot allow training on the use of guns. Therefore, they should not receive guns without the badly needed training. In comparison with the police officers, critics suggest that the violence encountered by EMS is different. In this regard, they hardly deal with people with guns, but the police often have to deal with gang members, robbers, and killers. The police officers deserve the gun because of their demanding line of duty, but the EMS does not need the guns (Grady and Revkin).

In this context, their profession makes them vulnerable to attacks, but guns are not one of them and in comparison with the police officers, they are not being shot at, stabbed or killed as the police. Others argue that more lives have been saved by EMS's policy of withdrawal from violent cases than when the EMS was using the guns. Interestingly, they suggest that when the emergency staff enters violent scenes they can run, but some of them, even after finding that the scene is one characterized by violence, they hardly withdraw from the scene, which predisposes them to a potential violence.

Although this is the case, the critics fail to acknowledge that the emergency service personnel do not have prior knowledge on the situation on the ground, which can predispose them to potential risk or even death. However, when the staff reaches the scene, regardless of whether it is violent, when they have guns, they can potentially stop any violence. In addition, critics ignore that the EMS are similar to other citizens, and their job is one that is full of risks (Boyle 760-763). They also do not have legal protection, authority, or capacity to act in case they find themselves in hostile situations.

Although they argue that the profession is inflexible, if there is a law that will require them to carry guns, then the profession can expand to accommodate subsequent training. Although the critics argue that the emergency workers hardly encounter similar situations such as those encountered by the police officers, they fail to recognize existing literature on the same. For example, the attacks on September 11, makes it clear that they often encounter harsh and violence cases, which endanger their lives. Evidence has also shown that paramedics are the most vulnerable staff because their field of work has many risks and uncertainties. In addition, all literature in this issue is consistent, in that the paramedic is always exposed to violence (Bullard).

In a quantitative paper survey, which involved the paramedics as the main participants empirical evidence indicated that the paramedics are in a field where violence is a common thing. Of the 1541 paramedics that took part in the survey, 70% were male and 30% were female. However, the findings of the survey show that the gender receives different violence, with women receiving sexual and verbal abuse, but men always received physical violence. Therefore, it is conclusive that paramedics are victims of violence when they are working (Mechem 401). Owing to the degree of violence, the paramedics often have to seek medical attention, while others die because of intense violence.

Why Paramedics Require Guns

In every society, there has to be critics. The job of critics is to provide their own perspectives on developing subjects, and it is not necessarily important for people to heed to their advice. All the same, it is important to appreciate their criticism. In this context, critics have felt that provision of guns to emergency personnel is likely to create possible tension. However, they fail to provide their views from the emergency services point-of-view. It is, therefore, recommended that prior to criticizing issues, critics can undertake research on the issue. If they do this, they will know the dangers associated when emergency personnel serve as first responders to emergency calls (Mechem 401).

The existing literatures suggest that emergency personnel encounter violence at high rates, and are almost impossible to respond to emergency scenes and come out without instances of violence. In this context, they sustain gunshot wounds, domestic fights, and stabbings. In such cases, the emergency personnel may have responded to acts of violence, and arrived when the violence is on progress. In addition, the emergency personnel lack prior knowledge of the scene and, hence; they are unable to determine the level of violence.

This is because dispatchers often lack the information, and during the instances, they often sustain injuries and subsequently risk their lives (Bullard). Apart from guns, EMS workers should be provided with bulletproof vests. Prior evidence is very clear on this issue. The main issue is the protection of the emergency workers. In many studies, particularly, in 1999, paramedics are shown to have received an average of 8 assaults for every paramedic. Most of the assaults were intense and resulted to trauma, fractures, dislocation, and other cases miscellaneous body injuries.

In addition, current literatures show that the case is not different from what appears on prior literatures. Emergency personnel continue encountering violence in their course of duty. From the time the dispatcher advices the staff on a possible case, the emergency worker becomes potentially vulnerable to violence, or even death. In most cases, the emergency workers have to deal with violence, which ranges from the drug overdose to gun fights. Therefore, if they have guns, they can handle such violence situations (Grange & Corbett 186-190).

On the other hand, there are some instance, which shows that attackers target the emergency workers, for example, during the columbine school shootings, bombing at Oklahoma Federal Building, release of gas in the New York subways, September attack on the world trade center and the pentagon. Although the emergency workers trained on how to save people, they are often required to encounter such acts of violence. This has added to their profession that they are to handle instance of violence without adequate protection ad weapons. Therefore, because it is as if they are to respond to acts of violence, then, it is only fair to provide safety gear and guns to enhance their response (Bigham).

What has been done?

There are American states that are in the process of arranging for the paramedics to receive guns. In other instances, the paramedics are not to respond to areas where there is supposedly intense violence (Bigham). However, this does not seem to be an effective approach considering that during dispatching, the paramedics lack prior knowledge. Recognizing that the EMS personnel are vulnerable to violence on the job, NEMSMA launched an enterprise tilted "end violence against paramedics," which will help in addressing the issue. Notably, its research also showed consistency with existing literature concerning the frequency of violence.

Their study shows that paramedics experience violence almost each time they respond to cases. In other states, the judiciary has filed cases against patients who attack paramedics. The project by the EMS governing body aims at educating the public against attacking the paramedics as they contribute a lot to the safety of citizens. To achieve the desired results, the body has collaborated with other organizations to provide anonymous reporting database. The results of the project are yet to be known, but even this will contribute less to end violence, particularly in cases when the attack involved weapons such as guns.

Considerations

The issue on whether it is appropriate for EMS personnel to use guns, either concealed or disclosed is raising substantial debate. In this regard, critics' opinions require weighing, mainly when the state or government finds it appropriate. Critics have stated that prior to issuing guns it is proper for the personnel to receive training on the same. Actually, this is a good point, and the employer should arrange for training. Training can take place during the weekends, or part time, and even in the night.

It is undisputable that arming EMS personnel can result to adverse effects, but considering that their working environment is full of uncertainties, then they should receive police training, and combat training (Kirkwood). Although they are trained to handle medical issues, the inclusion of response towards violence, will mean that the profession will have to change to include such training. Nonetheless, it is now time to approach the issue of providing EMS with guns considering every aspect of life.

In this context, the EMS staff is parents, children, and citizens. Because there is empirical evidence, which shows that the EMS staff are targets from government extremists, vicious gangs, infuriated drug users and criminals, it is only acceptable to allow them use guns, even if it is concealed to protect themselves on the job. In addition, although some people are quick to compare EMS staff to the police, there is an apparent similarity in the two job descriptions.