Where's Your Backup?

I remember the first time I transported an injured police officer. I was a new EMT, working with an experienced paramedic partner. The local police had tried to arrest a gentleman who didn’t want to be arrested. The conflicting desires of the police and the accused felon resulted in the initiation of a vehicle pursuit. (It was long enough ago that cops still did such things.) The car chase ended with a crash and short foot pursuit. During the vehicle pursuit, though, one of the police cruisers was involved in a separate frontal impact crash. The officer, being a police officer and knowing many car chases end with foot pursuits, was unrestrained in preparation for jumping out of his car and running. During his crash he hit his head on the windshield. He had a little forehead hematoma/abrasion and the windshield was starred, but the officer denied loss of consciousness and neck pain. As a matter of fact, he didn’t especially want to spend the rest of his day at the emergency department and sincerely did not want an ambulance to take him there. His sergeant essentially told him to shut up and forced him into the ambulance.

In the ambulance, the officer sat on the bench seat and my partner began disrobing him. (I remember thinking that police officers are much smaller people without all of the paraphernalia. Cops look like normal people; their vests and belts make them look fatter more buff.) He gave the officer’s uniform shirt, ballistic vest, and duty belt to the sergeant. The sergeant would take care of all his possessions, including the officer’s firearm. I put a backboard onto the bed (see – the call was a long time ago) and we moved the officer onto it. My partner had assured himself that Bill the New EMT could attend and moved to exit the ambulance. Before he did, he asked the officer: “Wait. Where’s your backup?” 

I thought he was talking to me, which was confusing. Why do I need backup with so many cops on scene? But the officer knew what he was being asked. He lifted his right foot off the backboard and shook it. My partner lifted his pant leg and removed the dinky revolver from the ankle holster. It was a cute little thing, as I recall. “Anything else?” my partner asked. The officer denied having anything else. “No knives?No backup backups? Throwdowns? Last chance…” The police officer had nothing else on him, apparently. We took him to the hospital.

If an Apache revolver is your backup gun, you can keep it. I'm certainly not getting involved with it...
By Latente Flickr [CC BY-SA 2.0], via Wikimedia Commons    

The call itself was no big deal, and it was not an uncommon EMS call. Police officers get injured. What made it stick in my mind was the search for backups and the ensuing conversation. I asked my partner about it after the job was done. He patiently explained that officers carry knives, backup firearms, and assorted throwdowns. Many officers (and people in general) carry folding knives in their pockets or clipped somewhere on their person. They are tools, used for everything from opening mail and cleaning fingernails to cutting seatbelts and even (I suppose) last-ditch fighting. A backup weapon is an extra firearm that the sergeant probably knows about. Backups are commonly carried on ankle holsters or occasionally attached to ballistic vests. Not every officer carries a backup, but some do. 

My partner explained that when police officers become patients, they sort-of cease to be police officers. It’s not true, of course, but it works as a model to discuss. Patients shouldn’t be armed. Head injured patients definitely shouldn’t be armed. Mental status can change suddenly and without warning. It is not an unbelievable progression to go from head injury to short seizure to post-ictal confusion. The last thing we want to deal with is an armed police officer after s/he has suddenly become altered, frightened, and can easily reach their heater. The risk is small, but easily avoidable by giving all the police accoutrements to another cop. 

In addition, my partner continued, duty belts are uncomfortable in the back of an ambulance. Further, they interfere with immobilization. The same thing is true of vests – ballistic vests raise the torso slightly, causing the head to fall posteriorly slightly more than would usually occur when a patient lies supine in a vest. Both belts and vests should come off. The shirt has to come off in order to take the vest off. We could take shirts, vests, and belts to the hospital with us, but officers are usually more comfortable with other cops being in possession of those kinds of objects. So we give it all to another police officer. It used to be a good idea to repeat the backup weapon search when the officer’s supervisor wasn’t around, in case we needed to be subtle getting a secret throwdown piece to a fellow officer rather than the supe. But that has become a non-issue over the years.  

Finally, removing all of those police-type items gives the subconscious impression to the officer they they are temporarily not a cop for the moment. Taking off all the crap subconsciously feels like going off duty to the officer. By taking off their duty belt, they become a person. It is easier to make a person a patient than it is to make a tough-guy (or worse, tough-gal) officer a patient.

Oh. The situation had been well-thought out and made sense. I’ve followed the practice since. I love to adopt good ideas. I’m lucky. In my system this is expected, so I don't need to explain the process to injured officers. The officers, other uninjured officers on scene, and supervisors all know what should happen. Everyone is down with the plan. Occasionally I need to remind them, but I’ve not had to have long discussions or negotiations. This process would hold true for me in any system, though. Good ideas are good ideas.