Your Captain Speaking: Not A Time to Call the Police

“Samantha, I’ve had a couple of situations where I thought about calling dispatch after I was on scene to send police to our location, but decided against it. Furthermore, having a ‘10-code’ set up with dispatch to call the police can produce bad unintended consequences.”

“OK, Dick, I’d love to hear about those calls.”

The call out was routine, it was a “Fall Down Go Boom” FDGB for short, not a 9-1-1 call so we proceeded without lights and siren per the caller’s request. As the door of the house opened, I was told “Hurry, Hurry!” with a very concerned look on their face. I turn the corner into the kitchen and laying on the floor is an elderly man with large kitchen knife in his abdomen and another man kneeling on the floor holdng the handle of the knife. Gulp!

“What’s going on here?” I asked.

The victim looked at me and said, “I should have used a gun.”

It was an attempted suicide, and the other man was stabilizing the knife and preventing additional wounds. Clarity, I love clarity.

A very serious call indeed. The family didn’t want the police on scene and so they didn’t call 9-1-1, who may have sent police. In truth, their grandfather did fall as their phone call stated, just not full disclosure.

What would have happened if we declared the scene as “not safe” and backed out until police were on scene? Significantly delayed patient care for sure. Could we treat, package, and transport the patient as a load and go safely? Yes! The family was helpful and followed our directions, even grandpa did what we asked. If we had radioed to send police, the whole situation could have spun out of control as anger displaced a helpful attitude.

How about a special 10-code with dispatch to send the police? Sounds like a good idea but in reality, would likely cause huge problems. Example: you give the code, and dispatch acknowledges but a minute later asks, “The sheriff department wants to know the reason.” Or perhaps an advisory that “Police response will be delayed.”

This is full of missteps. The police/sheriff will want to know if weapons are involved, type of incident, how many people, how many cars need to respond, etc. Sure enough, somebody is going to ask you “Why do you need the police?” which will be overheard by the folks on scene. Nothing good will happen. Any nearby ambulance units are likely to respond to see if they can help! Except, you may be putting them at risk; they don’t know the situation.

Another example. You are on scene of a motor vehicle collision and are back-boarding a patient when another man leans over and says, “You’d better take good care of him or I’ll burn your house down.” He had my attention! Now, is this time to get into an argument, stop patient care, and call for the police? My response was to advise my partner, “This patient is a load-and-go!”

Was he serious about burning my house down? I’ll never know, but I did tell him his friend will receive spectacular care, and we did just that. Just like the call before and the call afterwards. Would calling for police improve the situation or make it worse?

Key points:

• The situation may be so high risk that the best option is to back out quietly, stage to a safe place, and advise dispatch/9-1-1 of what you’re doing. The other family members and people on scene likely could challenge you as to why you’re leaving. Big mad possible.
• Load-and-go with the patient. Minimal time in disruptive environment and moves the patient to higher level care. Expect a concerned family member to tailgate the ambulance all the way to hospital. In this case, don’t run lights and siren as they will more than likely cause numerous traffic violations trying to follow you.
• Have a code set up with dispatch that you need police RIGHT NOW! Make sure this is with the understanding that they should not ask any follow up questions, but just to send them urgently.

Every call in EMS is different. Routine ones are sometimes anything but routine. Decide early if “the scene is safe” while totally understanding that a scene change quickly. Have options preplanned. Make your own judgement call, but make sure you consider the options. This is by no means telling you to “not call the police” in an unsafe situation. Rather, think, “Is calling the police going to make THIS situation worse?” Stay aware of your surroundings and the situation you’re in, and ask yourself, “Whatcha gonna do?

Dick Blanchet, (Retired) BS, MBA, worked as a Paramedic for Abbott EMS in St. Louis, MO, and Illinois for more than 22 years. He was also a Captain with Atlas Air for 22 years on the Boeing 747 with more than 21,000 flight hours. As a USAF pilot for 22 years, he flew the C-9 Nightingale Aeromedical aircraft. A USAF Academy graduate with a Bachelor of Science degree, his Masters in Business Administration is from Golden Gate University.

Samantha Greene has been a paramedic and field training officer for the Illinois Department of Public Health Region IV Southwestern Illinois EMS system for 17 years, a paramedic/FTO for Columbia (Ill.) EMS. She was formerly a House Supervisor at South City Hospital in St. Louis City, as well as an Emergency Department Paramedic. Recognized as a GMR Star of Life. Currently the EMS Liaison for Gateway Regional Medical Center in Granite City, Illinois, and EMS Coordinator for Madison City Fire Department.