Δευτέρα 18 Απριλίου 2016

Rapid Response: Resident shoots at responders, killing a paramedic and injuring a firefighter

What happened: Firefighter-paramedic John Ulmschneider and firefighter Kevin Swain were shot Friday evening after forcing entry in a home for a welfare check. Ulmschneider died from his injuries and Swain, 19, is now recovering.

Ulmschneider, Prince George's County Fire Department, and Swain, Morningside Volunteer Fire Department, were at the home at the request of the occupant's brother who reported the occupant had a history of diabetes.

Swain and Ulmschneider, as well as other firefighters, were told by the man's brother he was concerned about his brother's safety after his brother's phone was not answered and his car was parked in the driveway. The brother who made the 911 call was also shot and injured. Neither of their names have been released.

Police said a decision was made to force entry. As that was happening, the man inside fired several rounds. Once police officers got into the home, the gunfire stopped.

The occupant and shooter was released from custody Saturday evening and it is unknown if charges will be filed. Meanwhile we offer our condolences to the family, colleagues and friends of Ulmschneider, as well as our best wishes to Swain for a fast recovery.

Why it's significant: In January, firefighter Jason Adams, responding to a medical call, was shot and killed by the homeowner. The homeowner alleged he thought the firefighter was an intruder.

Paramedics, EMTs, firefighters and police officers frequently respond to calls to check on the welfare of a resident. Those calls run the gamut from a passerby report of a man down in a public park to concerned family, unable to reach an aging relative, calling from a thousand miles away. In some cases, like this incident, a relative or neighbor may attempt to contact or access the patient before calling 911.

Top takeaways: These takeaways are a call for reflection and conversation about the scenes you will respond to today and in the days and weeks ahead. Join us in honoring Ulmschneider's service while also discussing these points with your partner or company today or at your next station or department training.

1. There are no routine calls
This tragic incident is another reminder that danger potentially lurks behind every door or corner. The safety or danger of a scene is dynamic and risk assessment needs to be continuous.

2. Review welfare check protocols
It's not clear from available news if police were part of the initial response and on scene when the shooting started or only responded after shots were fire. Regardless, welfare check protocols and response configurations likely vary widely from community to community. Response is based on information provided to and gathered by dispatchers, previous experience with a caller, subject or location, and available resources at the time of the call.

3. Decision to force entry
Force entry is an option when there is no response from a home or vehicle occupant. The decision to force entry, much like the decision to use an offensive interior attack at a fire, significantly expands the potential risks to responders.

Use this incident to initiate conversations in your department about forcing entry for a medical call. How many personnel need to be on scene" Is the decision made at the field provider level or by a company officer or chief" What resources need to be on scene" Should the two-in, two-out rule apply to forcing entry for a medical call" What operational intelligence, such as 360-degree size-up and reverse 911 calls to the resident, needs to be gathered before forcing entry"

4. Body armor for every response
EMS agencies are increasingly purchasing or considering body armor for their personnel. Because there is no such thing as a routine call and even the seemingly benign or high frequency calls can unpredictably and quickly escalate, it makes sense that any PPE purchased by an employer be used on every call. As information is gathered and the scene changes, from roadside to ambulance compartment or front door to patient on a cot, paramedics and EMTs can adjust the PPE necessary.

What's next: The man turned himself into police after the shooting. He was later released and has yet to be charged.

On Saturday, a Pennsylvania man suspected to have overdosed received Narcan. He became responsive and attacked an EMT. This assailant is facing charges for aggravated assault and being held in jail on a $20,000 bail.

EMS providers are regularly injured in violent encounters with patients who have an altered level of consciousness. When a patient is under the influence of drugs or alcohol it is easy to say their actions are inexcusable and demand accountability for attacking medical personnel. For other causes of altered mental status or reduced level of consciousness, such as mental illness, hypoglycemia and post-ictal, it is less easy to connect the violent outburst to a level of civil or criminal responsibility.

Should the killer of Ulmschneider be charged with a crime" If yes, what crime"

Further reading: Learn more about violent encounters and body armor for EMS personnel with this collection of news and expert-written articles.

Violence and body armor:

Accountability for violent attacks on EMS personnel:

Body armor purchased for EMS personnel



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