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It seems like in these troubled economic times, more and more people are calling for EMTs to go above and beyond the call of duty. Which we’re perfectly happy to do, within reason. What falls outside the envelope of reason, you ask? Well first there was a story about Washington, D.C. EMTs and firefighters being asked to patrol high crime neighborhoods in the district at night, which I found to be a little distasteful (especially since there were three people injured in shootings near their patrol routes recently, calling into question both the safety and the efficacy of the policy). Then today I saw this lovely story about Ohio wanting to arm EMTs, and I gotta say that’s way over the line, even for me. And here’s why.

As some of you know, in my spare time (what’s left after writing for this site, at least) I’m a volunteer EMT for Fairfax County in Virginia. A couple nights every week a few of my close firends and I place an ambulance in service, meaning that we can be dispatched at any time to any place in the county for any medical emergency.

Last week I was hanging out in the fire station when I heard a neighboring company get dispatched for one of our boxes (FYI, a fire station’s area of responsibility is divided into “boxes,” and the assigned station is usually dispatched first to those boxes). At first I was disappointed, as it was getting a little late and I was bored sitting around with nothing to do. And then I heard the entire dispatch.

“Medic 440, Truck 440, Box 2108 for a shooting […] Stage pending P.D. instructions.”

Suddenly I was very, very happy that I wasn’t the one they tapped for that call. The county was very clear when I started riding that being armed while on duty was a big no-no, so even though I usually carry a concealed weapon when I’m in Virginia I am completely unarmed when I’m in uniform (except for the trauma shears). I quote from the SOP:

Firearms shall not be carried by on-duty personnel or on any Fire and Rescue Department equipment […]

And I completely agree with that policy for two very good reasons.

The first reason is that Fire & Rescue are not the police, and in order to do our jobs well we can’t be. When I roll up on an accident I couldn’t care less if you caused it. My priority is to save lives, ALL of the lives, regardless of any transgressions they committed.

The best example of where this separation comes in handy is when dealing with drug overdose patients. If you’re in an altered mental state, I need to assess very quickly what the cause is so I can set you straight. If you just shot up a needle full of heroin that’s information I need to know so I can get the naloxone ready; if you don’t tell me then there’s a good chance you’re going to die before I can get you to the emergency room.

In a situation where there’s one or two extremely high people in my ambulance, the one phrase that seems to magically extract that information in a hurry is “I’m not the police, I can’t turn you in for whatever you took.” It works like a goddamned charm. If EMTs start carrying guns, then that clear separation becomes a little murky. “You say you’re not a cop, but you carry a gun!” I hear the crackheads yelling in response.

I hear the Armed Intelligentsia responding, “If you’re able to be dispatched to a shooting at a moment’s notice, wouldn’t you want to be armed?” And the answer (coincidentally reason #2) is no, I wouldn’t. That’s the police department’s job.

I know there’s at least one EMT reading this blog, so say it with me buddy.

  1. Scene Safe?
  2. BSI

Everything we EMTs do is off a checklist, and just like airline pilots have their pre-flight checks, EMTs have our master list of questions to ask ourselves. Any time we get dispatched the very first question we ask ourselves is “is the scene safe?” If the answer is no, we park some distance away and wait until it is. If you look back on the dispatch at the top of the article you’ll notice it tells them to “Stage pending P.D. instructions,” which is code for “wait until the police say it’s clear.”

I don’t care if you’re bleeding out, I’m going to park my ambulance down the block until the police clear me to proceed. The mantra of any good ambulance officer is “first my crew, then other first responders, then the patient, then the public.” It’s the order in which we care about people’s well being. You may be in trouble right now, but my crew and I do this day in and day out. Yes you may die, and that sucks, but my crew and I are going home at the end of the night so we can keep helping people in the future.

Would having armed EMTs mean they can go into dangerous situations sooner? Yes, it would. But it would be a horrible idea. When you’re on scene, once you’ve determined it’s safe the ambulance crew usually focuses all of their attention inwards towards the patient. We’re focused on saving their life and performing our interventions and not on the crowd or external threats. Our situational awareness encompasses an area about the size of a small truck, and that’s it. The police, on the other hand, should have their situational awareness focused outwards towards the crowd and emerging threats. There’s nothing they can do for our patient, and the only reason they’re on scene is to keep us safe. Arming EMTs sounds like an excuse to send fewer police per dispatch, and when all of the EMTs are distracted it provides an excellent opportunity for a shooter to finish the job they started (my patient).

To be clear, the story that started me down this rant was about arming EMTs during SWAT raids. There’s a specialization in EMS that trains medics to go in with SWAT teams, but until now they’ve always been unarmed. There was nothing in the story about arming medics in general.

But the second you hand a gun to an EMT, the entire foundation of trust we’ve built with the community goes crumbling down. No other service in the United States is invited into people’s homes when they’re at their most vulnerable, complete strangers showing up when they’re most needed to lend a helping hand. If the public thinks those strangers are going to be armed they may think twice about picking up the phone and making the call that saves their lives. It’s an interesting contradiction: arming EMTs to protect their lives may end up costing the public theirs.

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  1. I think law enforcement and EMT work are just too different, and it’s impossible to do both those jobs well simultaneously. If you want to have some kind of LEO ride along with the EMTs I’m ready to hear your proposal, but I don’t think EMTs should be packing heat.

    Arming sanitation workers though, that’s worth talking about 🙂

  2. The response I hear most often on this site when refering to the police and allowing them to carry in situtations in which you yourself cannot is, “Why would you want to willingingly create a situation in which your safety depends on someone else.” Wouldn’t you rather be responsible for your own safety rather than depend on the police? My other question is what if you are called to scence in which it is unknown wether or not there are armed “guests” waiting for you, wouldnt you rather have a firearm on you just in-case?

    • If we were talking about the general public I’d agree with you entirely. But unlike the general public EMTs specifically have the police clearing the way for them.

      I’m curious though, is there much incidence of EMT’s being ambushed for whatever reason? If there is then I’d have to rethink my opinion.

      • I know in Israel and other countries that have to deal directly with terrorist attacks on a daily basis, one of the M.O.s is to set off a bomb, wait until the emergency crews respond, then either attack them with snipers or simply set off another bomb. I don’t think that’s happened here yet. But the century is young.

    • It is akin to arming or using as spies Peace Corps or Red Cross volunteers. If it is ever done once anywhere, the system is destroyed forever everywhere.

  3. Hey I am an emt and work in the inner city. I cant believe what you are saying. You sound like such a hypocrite right now. I understand some of your points but they dont apply to ccw. I have been assaulted twice on duty and dispatched incorrectly to gsw’s without a standback notice. one of our medics was shot years ago and my friend had a gun put to his head when he was parked just sitting in his ambulance. I guess since you dont want to carry a gun nobody else should be aloud to right?

    • I’m talking about systematically arming EMTs, not CCW. If someone wants to carry CONCEALED on a rig that’s cool (excuse me if I don’t choose to), but the second you issue them as standard equipment I start having problems.

      • What if the standard is concealed? I can see why an EMT might not want to carry on his hip like Five-O, but wouldn’t concealed carry take care of this issue?

        • i understand that some situations it would *MAYBE* be ok to be carrying, but if it becomes standard to carry while on the job, I can already see myself being dispatched to a chest pain call, opening the door, and having a gun pointed at me so they can take my gun that I am now carrying!! essentially i would be forced to clear an entire area before i even can think about treating a patient.

  4. EMT’s have a right to protect themselves in the tough areas of town, and if an EMT shoots you he can at least try to save you. Now if you get shot by a cop your screwed(I’m assuming that the cop actually hits you) until an EMT gets there to save your ass.

    • I gotta admit, getting shot by an EMT kinda defeats the purpose, your gonna shoot them, and then save them. I say do one or the other, if an EMT shoots you in a leaglly justified shooting, he doesn’t have to sow you up if he misses, you have to wait for another EMT to save your ass. In all seriousness I am kinda devided on this issue. I can see both sides, on the one hand it would be like issueing the Peace Corps assualt rifles, and on the other your painting a target on a mobile pharmacy and not allowing them to defend themselves.

      • we as a division of healthcare have worked hard for our reputation of helping people. like Leghorn said, people invite us into their homes, allow us to do some pretty invasive procedures, and then thank us for doing it. we have all worked hard to earn this respect and level of confidence in our patients and adding a gun into this mix, would truly defeat the purpose.

  5. I do not think EMTs should be armed by the group they work for. I think Nick is right, that is not their focus. I do think they should be allowed to CCW if they choose for self protection. Not so they can enforce laws, but for when SHTF and there is not an Officer present. They should have the choice to carry a self defence weapon without being required to help in police duties.

  6. Nick’s absolutely right that scene safety is the number one concern drilled into anyone that completes EMS training. Despite the fictionalized depiction of EMS by a few TV shows, EMTs are taught not to knowingly enter unsafe situations. The point being — situational awareness and close cooperation with the police will always be an EMT’s number one defense.

    My experience as an EMT was very limited — I completed the training and earned my certification but spent little time actually working as an EMT. So I’m curious, Nick, if you think that being armed in such a confined space is *ever* a good idea when your nearly complete focus (and often both hands) will be on your patient?

      • Chest pain call. No cops present. Two EMTs working on a patient. BANG! Your fellow EMT slumps down. Would you rather stand there like a deer in someone’s headlights???

        Chances of that happening is rare, but why do people CC day to day? Because the probability of that happening is non-zero. Should an EMT choose to carry concealed, that is his choice. Systematically arming them- no.

  7. “You say you’re not a cop, but you carry a gun!” I hear the crackheads yelling in response.

    This may sound a bit cold; let the ‘crackhead’ decide whether he/she prefers medical treatment or a nomination for The Darwin Award.

  8. EMT’s have the right to defend themselves and should be allowed to carry. Concealed might be better if you prefer.

    Making them untrained police officers is full of fail (and a separate issue).

  9. Scenes are NEVER safe. Personally I’m really surprised that people don’t make fake calls to stage narc ripoffs.

    It’s total bullshit to claim that “but until now they’ve always been unarmed. ” TEMS medics are sometimes armed, or sometimes not. It depends on the department. Some departments will try to recruit experienced paramedics as cops to be their TEMS guys, some will make deal with the fire dept and make some FD PMs reserve officers, and there are lots of other ways people have done this. Sometimes they will not be armed, but that means you need to have at least one officer providing security for them all the time. When they are providing care they will need security whether they are armed or not.

    Anyhow, there a lot of areas where police officers provide EMS service. For example, the Ingham County, MI Sheriff’s department. I know they have done this from the early 80s, so it obviously at least kind-of works.

    So no, I don’t see it as impossible to combine the two.

    I can see ways it could go terribly bad too. But for a TEMS medic, damn right they should be armed. They are going into the hot zone with the entry team.

    • wait a second…all the swat medics I’ve ever spoken with have told me that they are armed when going in with the team. this ISN’T SOP in some places?! that’s just dumb. all my comments before this one is in regards to every day 911 emergency medical call medics/emts. going into a known hostile area with a team of guys WITH guns and you are not? suicidal much?

      I’ve trained with several TEMS units from South Florida and several military units and they have always been armed medical personnel

  10. I think if we’re talking an EMT who is attached to a SWAT team then they should have the choice to be armed if they want. They could be going into some dangerous situations. Regular medics rolling around in a bus all day waiting for a call is a different story.

  11. Scene safe?

    I’m with you after your clarification about CCW. I read the posting initially to say that you believed that carrying a firearm at any time was fundamentally incompatible with functioning as an EMT, which I disagree with.

    Funny that the proposal is coming out of Ohio – last time I checked, the state board here does not recognize TEMS (tactical EMS) as a certification or subspecialty. My assumption from exploring TEMS training on my own is that an EMT or Medic associated with a SWAT team is typically armed. I’d like to spend some time training with the PD, but I think they tend to want only Medics.

    Currently, I do not frequently carry concealed firearms while working on the squad, but have, and sometimes do. I have a fair number of blades on me as part of my standard load out. As a volunteer, with a day job, I am out on a lot of evening and overnight runs, and for some reason, many of our hospitals are surrounded by some pretty dicy areas at 3am. Someone looking to steal meds will not necessarily be swayed by the finer points of “we’re a basic squad, and don’t carry drugs..”

  12. I know a few EMTs who have admitted to CCWing on duty. But mostly because they’ve been assaulted at one time or another while on duty. It’s apparently not the calls they have problems with, but coming and going from the stations.

  13. Greetings:

    In Utah, the Davis County Sheriff deputies are firefighter/paramedics, and the same is true of some other Utah communities, or at least, that’s how it was years ago when I lived there.

    I always wore my concealed revolver when I was an EMT in rural Idaho.

    I never needed it, but I felt it was my civic responsibility to always be prepared for any sort of emergency.

    In rural areas of the far West, it’s not uncommon for a lone deputy sheriff to be many, many miles away when local volunteer firefighters and EMTs are on the scene at a remote ranch or an isolated mountain highway.

    Personally, I think EVERY citizen in the United States of America should be trained as an EMT, should be armed at all times, and have their personal vehicle equipped with proper rescue and firefighting tools for emergency response.

    Our society would be so much safer and more responsible in their conduct.

    Thank you.

    John Robert Mallernee
    Armed Forces Retirement Home
    Gulfport, Mississippi 39507

  14. There will come a time when something unexpected happens on a supposedly Safe Scene ,without backup, and that’s why you should carry.

  15. I’ve read that EMS and fire personnel have been attacked when responding to both real and fake call-in emergencies.
    I have no issue with them carrying openly or concealed, however I can see firemen having issues with their heavy protective gear, hoses and devices possibly interfering with a traditionally carried sidearm.
    For EMTs, not so much although in the close confines of an ambulance and the generally short proximity between them and victims, weapon retention gear and training become extra important.

    • As a fireman you have a (LTL) powerful water hose and axe/haligan tool etc at your disposal. It’s different to an EMT being limit to a scalpel since they can’t legally CC.

      • True, a fair number of firemen’s tools can be used as fairly potent improvised weapons.
        I’m just saying that drawing and even retention of any sidearm could be complicated by the tight maneuvering around trucks and stairwells, handling of tools and hoses, etc.

  16. EMTs are generally focused on other more pressing matters then weapon retention, and rightfully so. However they also are likely to find themselves in unknown and uncontrolled situations.

    I would be in favor of allowing EMTs to carry in deep cover when on duty. As it stands, it is expressly prohibited for an EMT to CCW in at least one of the ambulance services near where I live now. I don’t think that is right (that is a rule to protect the ambulance company from legal suits at the expense of the EMTs working at risk… NOT cool.)

  17. You’re confusing duty with self preservation. Being armed does not mean you need to act in a law enforcement capacity. However, it does give you the option to defend yourself should you be placed in a bad situation. I find it silly that people think that when they wear a gun that they must act, which is untrue. In fact, wearing a gun likely means that you should act less, and only when it’s necessary to defend a life. So, I say allow anyone who wants to be armed to be armed. If they can be entrusted to save lives, and carry when off duty, then why not allow the combination of those things? Just because YOU personally don’t think it’s needed, doesn’t mean someone else feels the same way. Stop imposing YOUR views on the other people, some of us like being armed while at work.

  18. Everyone has a right to self defense.

    Why does this have to be about protecting others? Can’t they just carry a gun for self defense like so many of the rest of us do on a daily basis?

  19. Have to agree, but disagree. [grin]

    I agree that EMTs wearing duty equipment and a service-size pistol would be an extremely bad idea, not the least of which is the potential for a gun-grab by a whacked-out PSP subject. Never mind your level 2 or 3 retention holster. Even if the whack job can’t get it out of the holster, its mere presence could conceivably invoke an attempt which could get you hurt trying to retain it and get him under control.

    However, I disagree that EMTs should not be armed. There is a big difference between a big Sig in a rig, and a concealed LCP wearing Cobraskin in your strong-side hip pocket. The second option is not only safe, it should be recommended. Screw the odds. Anyone who draws breath could be the exception, and that could be YOU.

  20. I am a strong advocate of being armed at all times in all places but Nick’s logic here is very sound.

    Well stated Nick!

  21. By some of the comments, it looks like some are missing the point of the Bill. It appears to be meant for EMT working with SWAT teams. I am a full time medic but also of three paramedics on our EMS service that are provide medical support for our local SWAT team. Our SWAT team is normally only a 10 member team, not counting us medics, and medics are unarmed. We are there to povide medical support in an area that may not yet be secured for the SWAT members, inocent victoms, and suspects. Depending on the operation 1-2 medic stage at last point of cover or point of entry. It normally takes one officer out of service to provide cover for us. As I said we are not armed but we do train on use and making safe officers weapons and as ammunition budget allows qualify with them. We also wear full body armor and tactical gear. Arming tactical medics makes sense for the safety of the medics and officers if things would go bad. Sometimes care needs to be rendered in an eviroment that normal EMS and Fire are not trained or equiped to be in. It’s really not different than military medics being armed with a sidearm for their own defense!

  22. As a fellow EMT (I’m actually on duty as I write this), I must say that this article is extremely insightful. You’re absolutely right when you stated that telling patients we are not police officers and what they tell us cannot be used in court is necessary.

    Another example to suport your thesis: if a Police Officer and suspect trade gunfire, the patient with most severe injuries is treated first. That means that the suspect would go to the hospital before the Officer if the suspect had a GSW to the chest and the Officer had one to the arm. Controversial or not, this saves lives. Arming EMTs would reduce the public’s trust of us and the perceived ‘duty’ of being armed (i.e. becoming somewhat of a LEO during calls) could affect our judgement when it comes to triage.

    That being said, I must also acknowledge that in some places Police are rarely present. While one may be able to wait for PD arrival for a shooting, some situations can turn violent easily. So, as someone earlier stated in comments, I must say that carrying should not be done systematically (“all EMTs must carry”) but should be something of a civilian choice with the same civilian responsibilities (i.e. the EMT may only draw his firearm when presented with deadly force, not draw when a suspect is fleeing).

    Thank You for posting this wonderful article!

  23. I know I have no “dog in this hunt” because I am not an EMT, however; speaking from the civilian side, I have to say that I would have no problem with an EMT carrying concealed to protect him/herself. I completely respect the thoughts and experience of Mr. Leghorn. Who would know better than an EMT what the pros and cons of armed Emergency Medical Techs? His commentary is logical and well-written.

    I must respectfully disagree with Mr. Leghorn’s summation with one exception. It should not be Ohio’s decision whether an EMT is required to carry or not. In my opinion, it should be up to the individual. Requiring ALL Emt’s to carry is no more reasonable than forbidding any from doing so. Those who would choose not to carry should not be forced to do so. At the same time, those who choose to do so, should not be precluded by company/city/county/state policy. Choosing to carry a CCW is, no more and no less significant than carrying jumper cables and a car jack in your car. No one sets out to have a flat tire or a dead battery, but when it happens, it is best to be prepared. That’s how I feel about CHL laws and carrying concealed. Nobody expects bad things to happen, quite the contrary, you hope it never happens to you or your family. . . but if you are the 15% who prefer to be prepared, then I would not be one to fault your preparedness.

    Stepping back and looking objectively at the lives of two people, one is an EMT and one is an Actuarial accountant for an insurance company. . . . which one is MORE likely to run into a Meth addict during the course of their job? Which one is more likely to deal with people at times of high stress, great emotions, and misplaced rage?

    I would sincerely hope that the state of Ohio is not asking its EMT’s to become another arm of Law Enforcement, as is suggested by the article. That is a horrible idea for a litany of reasons, including those Mr. Leghorn already mentioned so I won’t repeat them. But if it is merely a matter of permitting personal protection for its valued members of First Responders, then I cannot find fault. Mr. Leghorn explains the hierarchy of responsibility and I agree with it. Crew, other responders, then patient. If an “all-clear” is mistakenly given or a threat arises after their arrival, then the hierarchy of responsibility still stands, only now, maintaining distance from the scene is not an option.

    Two last thoughts before I end my ramble. Like I said before, I have no skin in this game. I am not an EMT, I just respect them for the job they do, so I support them . . . more so than some of the people they treat. I value an EMT’s life more than a meth addict on a bad trip trying to hurt himself or others. Pick your own example. A person who places their life in jeopardy for the sake of another, is more important to me than one who risks other peoples life and safety for their own selfish purposes. That is why I want to guard against threats to the good guys. The good guys deserve our respect and support.

    Finally, if, as Mr. Leghorn suggests, the presence of a CCW threatens the appearance of confidentiality so that a patient will not volunteer information about what they have taken or what they have done. . . .then I would suggest that the situation could best be addressed by adhering to the first letter in the acronym CCW. “CONCEALED” carry would prevent giving the false appearance of being connected to Law Enforcement, while still permitting an EMT who chooses to carry to do so legally. It would be no different than ordinary citizens in States with CHL laws. Bad guys don’t know who is armed and who isn’t, so it’s best to assume everyone is armed. Stupid people who have overdosed don’t have to fear giving evidence against themselves to an armed EMT who they might confuse with Law Enforcement, because they will never know the EMT is armed.

    Wish you all the best, thank you for your service to your community!!!!!

  24. Read the intent of this Bill! Horrible story that misinforms the intent. It is for SWAT or SRT Medics and is used as a last resort self preservation tool!

  25. I retired from police service & now work as volunteer & part time EMS. I don’t see open carry at this time, I believe this could cause an altered state person to create a situation whether you carry open as a citizen or EMS or any other situation. A bad ass or other may want to
    Take you on or exacerbate a situation. but I carry CCW. On or off duty. No citizen has ever detected this in daily life or on the job. Do it right if
    You are gonna do it.

  26. “Yes you may die, and that sucks, but my crew and I are going home at the end of the night”

    Well, you’ve already got the mindset of a cop, might as well carry. Screw the public, whatever it takes to get home, right?

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