Are you defensive?

Replies to This Discussion

Permalink Reply by Jen on July 16, 2009 at 8:24pm

I do agree that Kali-Silat is very versatile. What I mean by the bad day is... my studio teaches nothing about the legal aspects of self-defense, scene safety, how to handle patients, which patients to look our for, etc.

If a person has martial arts training AND is proficient, they will probably do just fine in a situation, however, do they know where to stop defending themselves? Do they know when it is too much?

I'm not saying martial arts is bad by any means. But what do the folks coming out of school do? There needs to be something that they can use without having to spend years in a martial arts studio.

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Permalink Reply by Scott G on July 16, 2009 at 8:58pm

After studying Aikido, Hapkido, Tang soo do, Tae Kwan Do, Kung Fu, and Kempo, I would have to say that Aikido and Kempo are two of the most important styles when working in EMS. Yes it would be nice sometimes to put someone in an armbar or Kimora, that puts us at a very high liability, as the goal of these techniques, ultimately requires a grappling situation, and if not grappling, at the very least has the goal and potential of breaking a joint (something that can be civilly sued as well due to the function that may be lost). Aikido is mainly a defensive style, so as such, at it's core only uses the same amount of force that a subject puts into the attack. The joint locks and whatnot have the possibility of injuring somebody, but if you are to the point where you can use a joint lock safely, I say go for it. Kempo I recommend as well because it is mainly most effective in close quarters when the subject is close to you. From here, you are able to use various techniques to end the situation.

I speak only out of personal experience working with violent patients on the ambulances and in the emergency room. Scene safety is always something that should be considered first in order to CYA. That being said, hopefully you will never encounter the situation. But that is only on the books. We all know how different actual calls are from textbook examples. To CYA, it is essential that you only use the same amount of force that a subject puts into an attack and no further. People have the innate tendency to continue from adrenaline after the attack. Once the attacker is subdued, in four or more restraints (Yes, I have seen someone in 12 point restraints in the hospital) the force should end.

In closing, I would never want to go into the field without the skills that i have learned over a LIFETIME. One or two classes are good, but there is no substitution for dedication to an art. It becomes part of you. When I was put into a choke hold by a drunk, I instinctively performed a simple but very effective wrist lock technique without even batting an eye. It took maybe 2 seconds to immobilize him. There are drugs out there, ie PCP, that people take that may make them feel no pain. In this sort of situation, there is no substitute for lots of people and lots of force. Use anything and everything you can. Sometimes an oxygen bottle to a pressure point or a clipboard to the throat may be needed. Finally, if your life is in jeopardy, you have no choice but to use lethal force. Many styles teach it, but it should ONLY be used when your life is in immediate danger, you have no escape route, and there are no other solutions.

I think that covers about all. I hope this helps and illuminates the issue!

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Permalink Reply by Don Zaidle on July 16, 2009 at 10:36pm

Not only do I disagree with the entire premise of the article, I believe the advice given is plain wrong.

"Place items inside the scene, such as ammunition boxes, outdoor magazines or hunting trophies, that may indicate the presence of traditional weapons, such as firearms and knives. Boxing gloves, martial arts uniforms or certain photos may suggest the patient or others have training in boxing, wrestling or martial arts. Uniforms, unit patches, awards and badges may indicate military or law enforcement training. ... Give your personnel the opportunity to recognize these indicators of possible threats, and practice withdrawing from the area or calling for law enforcement assistance."

When I read those lines, I thought, "That sounds like typical cop paranoia." Then I got to the end and learned I was right.

Unless the patient or family members are already violent or making threats (in which case EMS should not be there in the first place, but staged waiting for law enforcement), to "withdraw" or "call for law enforcement assistance" because there is a copy of Field & Stream on the coffee table or a set of karate ghis on the ironing board is absurd.

Here's better advice: Note items in the residence that hint at the patient's interests, then use this knowledge to establish a rapport with the patient.

Abandoning a patient because of a deer mount on the wall is the stuff lawsuits are made of.

"Withdrawing" based on "POSSIBLE threats" based on magazines, sport clothing, or military unit patches is just plain paranoid foolishness. By that assessment, a kitchen in the home poses more "possible threats" than a dojo full of blackbelts. Pan of boiling water or hot grease in the face, anyone? A meat tenderizer to the temple? A chef's knife to the ribs? An icepick in the eye?

Please, threats come from individuals, not objects. Assess the patient and bystanders for mental status and attitude. As long as guns are in the cabinet and not in the patient's lap, the baseball bat is in the kid's athletic bag in the corner and not in a screaming bystander's hands, and the knives in the kitchen drawer, there is not much to worry about. Knowing these objects are there in case someone makes a move for them is one thing, but "withdrawing" or calling in law enforcement merely because the objects are there is quite another.

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Permalink Reply by Jen on July 16, 2009 at 10:39pm

And an O2 bottle to the head is considered deadly force, hopefully this kind of force is justified when you use it. :)

Chance Gearheart said:

I know the art of O2 Fu.

An o2 tank has a reach of two feet beyond your arm, makes a satisfying ding sound when contacting the human cranium, and makes a great improvised weapon if someone comes at you with a knife.

Not that I...know this or anything.

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Permalink Reply by Ben Waller on July 16, 2009 at 10:53pm

I agree,

I've occasionally dropped a steak knife behind a bedroom dresser if something with the patient or family didn't feel right. The key is watching body language and hand position. The patient can't choke, stab, or shoot you with his/her feet, teeth, or angry expression.

The best defense I've found are, in order:

1) Aggressive and enforced staging policy on violent or iffy calls.
2) Wear body armor on any call that requires staging, in sketchy places, or whenever you think it's warrented.
EMS vest-style armor in an external carrier works well for this.
3) Pay attention to your surroundings, and never run in to any call.
4) Have someone watch your back, all the time, if you're the primary caregiver. Cops and engine companies are your friends on this one.
5) Don't let yourself get cornered.
6) If the situation is hostile, you can indeed back out. It is entirely permissable to abandon the patient in order to save your own life...dead paramedics have helped their last patient.
7) If there are obvious weapons, get the patient out of the environment as soon as possible.
8) If you have adequate help, position some of them between the weapons and the people that might be tempted to use them.
9) Formal training in savate, karate, judo, or other martial art can be helpful, but not if you are ambushed with a firearm.
10) Have a MAYDAY or equivalent way to tell dispatch that you are in trouble and need lots of LEO help immediately. Practice it in training so that it's not a surprise to everyone if you have to use it in the field.

Or...do what I do...just send Tom. :-)

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Permalink Reply by Scott G on July 17, 2009 at 11:03am

Well, luckily with Aikido, you do not have to be a blackbelt in order to successfully defend yourself. It becomes part of second nature the more you do it. When I was speaking of the time commitment, I only said that to say that these one or two day clinics (like most people think) are not enough to have them ingrained in your mind and become second nature. As you know, when you think, you can die. Hope you all can benefit from my information and encourage any comments/questions!

asysin2leads said:

Alright! I'm glad I'm not the only one who has found aikido useful in the field. The technique I've actually used the dodge and wrist grab when a punch is thrown. I never said I was a black belt in aikido.

Scott G said:

After studying Aikido, Hapkido, Tang soo do, Tae Kwan Do, Kung Fu, and Kempo, I would have to say that Aikido and Kempo are two of the most important styles when working in EMS. Yes it would be nice sometimes to put someone in an armbar or Kimora, that puts us at a very high liability, as the goal of these techniques, ultimately requires a grappling situation, and if not grappling, at the very least has the goal and potential of breaking a joint (something that can be civilly sued as well due to the function that may be lost). Aikido is mainly a defensive style, so as such, at it's core only uses the same amount of force that a subject puts into the attack. The joint locks and whatnot have the possibility of injuring somebody, but if you are to the point where you can use a joint lock safely, I say go for it. Kempo I recommend as well because it is mainly most effective in close quarters when the subject is close to you. From here, you are able to use various techniques to end the situation.

I speak only out of personal experience working with violent patients on the ambulances and in the emergency room. Scene safety is always something that should be considered first in order to CYA. That being said, hopefully you will never encounter the situation. But that is only on the books. We all know how different actual calls are from textbook examples. To CYA, it is essential that you only use the same amount of force that a subject puts into an attack and no further. People have the innate tendency to continue from adrenaline after the attack. Once the attacker is subdued, in four or more restraints (Yes, I have seen someone in 12 point restraints in the hospital) the force should end.

In closing, I would never want to go into the field without the skills that i have learned over a LIFETIME. One or two classes are good, but there is no substitution for dedication to an art. It becomes part of you. When I was put into a choke hold by a drunk, I instinctively performed a simple but very effective wrist lock technique without even batting an eye. It took maybe 2 seconds to immobilize him. There are drugs out there, ie PCP, that people take that may make them feel no pain. In this sort of situation, there is no substitute for lots of people and lots of force. Use anything and everything you can. Sometimes an oxygen bottle to a pressure point or a clipboard to the throat may be needed. Finally, if your life is in jeopardy, you have no choice but to use lethal force. Many styles teach it, but it should ONLY be used when your life is in immediate danger, you have no escape route, and there are no other solutions.

I think that covers about all. I hope this helps and illuminates the issue!

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Permalink Reply by Jen on July 17, 2009 at 12:41pm

Yeah I would say so!

Chance Gearheart said:

It was for my old partner at the time. He's got the stab wound from a steak knife to prove it. Escalation to deadly force is justified if your life is in immediate, obvious danger without action. Someone coming at you full blast with a knife poised to attack is a justifiable answer.

Jen said:

And an O2 bottle to the head is considered deadly force, hopefully this kind of force is justified when you use it. :)
Chance Gearheart said:

I know the art of O2 Fu.

An o2 tank has a reach of two feet beyond your arm, makes a satisfying ding sound when contacting the human cranium, and makes a great improvised weapon if someone comes at you with a knife. Not that I...know this or anything.

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Permalink Reply by david heuthe on July 19, 2009 at 8:40pm

i've been training in Jiu Jitsu for 10 yrs. The reason is because while working as a medic in NYC i was in a situation where I was confronted by a violent patient. My partner called a 10-13. in 5 min. 2 police cars,1 detective unit,2 buse sand 1 fdny Lt were on scene. by that time i had been able to calm the patient. I thought"what if I hadn't been able to control him?" 5 min. though a fast response time may not have been fast enough. That's when i started to train and it has served me well. I have been in situations where I have had to use my skills as a martial artist and am glad to say that it has resulted in no injuries to myself or my patients. My goal is always to go home safe and for 10 + yrs i've been able to do that.

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Permalink Reply by Frank Lenoir on July 20, 2009 at 12:24am

I actually think that most of us have -0- business operating tasers (I can see the "new guy" tasing someone on O2), or God help us, chemical munitions (even basic pepper spray). However, I am an ex-cop / correctional officer, and taught PPCT (Pressure Point Control Tactics) to a LOT of officers. I think that would be ideal for EMS. Although some takedowns and locks can cause injury, the majority of the control tactics employ very simple application of pressure to nerve centers until compliance is gained. This usually causes minimal, if any, injury, and I know I would feel more confident if our service held training, and encouraged good-sense use of, PPCT. And honestly, if we're in a situation that requires any level of force above that, we're gunna need backup regardless. :)

My humble $.02 ...

Jen said:

Bryce, I agree with you. Kevin, I can see your point. I am a tactical medic as well and at this point in time, we are unarmed and I don't see us becoming armed (with anything) in the near future. As much as I hate to admit it, Kevin you are probably right about the physical condition of non Fire EMS folk (that is a whole topic in itself). However, I agree with Bryce, I don't see us obtaining Tazers or anything like that in the near future. If this is the case, why not prepare EMS the best way possible? Is it fair to not train EMS because we are waiting for tazers, etc? Self Defense is not pretty, it is dirty and ugly, but it gets the job done. Yes, martial arts can and does take years to become proficient but there are some basic tactics that can be used.

-Jen
www.dt4ems.net

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Permalink Reply by Frank Lenoir on July 20, 2009 at 12:30am

That's hilarious! XD

Chance Gearheart said:

I know the art of O2 Fu.

An o2 tank has a reach of two feet beyond your arm, makes a satisfying ding sound when contacting the human cranium, and makes a great improvised weapon if someone comes at you with a knife.

Not that I...know this or anything.

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Permalink Reply by Jen on July 21, 2009 at 3:04pm

While Pressure Point Control can work on some, they do not work on all. You also have to be close to a patient to use pressure points.. you shouldn't stay close enough to the person long enough to apply a pressure point.

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