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EMT’s and Crime Scenes

The streets are buzzing with talk of the recent New York and New Jersey bombings and the arrest of the suspect, Ahmad Khan Rahami.

Now what does this have to do with an EMT blog?
A lot 
Take this excerpt from a New York Times article:

“Mr. Rahami, blood pouring from a wound in his shoulder and splattered on his face, was loaded onto a stretcher and taken to University Hospital in Newark.”

This is just one of the many instances when emergency medical care and the criminal justice system collide. You may shy away at the thought – treating a deadly criminal? Why should you waste your energy, skills, and good medical equipment, on a man who tries to kill?

But the truth is, by saving a criminal’s life, you may be helping his victims. And in a case such as this, where it is an act of terror, you may play a role in preventing similar incidents in the future. If the criminal is alive and in stable condition, he can be questioned by law enforcement agencies and the court. The information they gain through this is usually highly valuable.

Approaching a Crime Scene

When you approach the crime scene, as an EMT, your job remains the same – to save lives and give appropriate medical care. However, there are several other things you’ll need to be aware of.

1) Don’t Become a Victim!
Before anything, you need to make sure that you are not in danger of becoming a victim yourself. Unless you were trained as a tactical EMT, you are not required to enter a “hot” or “warm” zone (where there is still active violence or a chance of violence.) 
Only once the scene was given the all-clear and the criminal is neutralized should you enter and begin triage and treatment.

2) Be Aware 
The patient was lying on the couch? Take note. You moved a table to get to him? Remember where it was originally. 
In one instance, investigators wasted a lot of time because they thought a witness had moved things around after the crime. In reality, the paramedic had moved some items to gain access to the victim, but had not informed anyone of this. (Journal of Emergency Medical Services, Crime Scenes: Documenting Assessment and management of crime victims.)

3) Document Everything
You may be so preoccupied with giving care that you give just a perfunctory documentation of the event. Don’t do that.
Especially if you were one of the first at the scene, chances are, you’ll be called in as a witness. In addition, because the defense will be looking for a way to get the criminal off the hook, they can even try to shift the blame onto you! 
So make sure you recall every detail and document it as soon as you can. Especially take note of anything you moved on or near the patient’s body, anything the patient or bystanders say to you, and what treatments you administered.

4) Record Facts
Only write down things that are objective – not the conclusions you drew. For example, don’t write if it was a knife or bullet wound; just describe the way the wound looked. Don’t identify a person as “intoxicated”; just describe his behavior and the smell of his breath. Leave the conclusions to the court.

You may feel that EMT’s are not police – and you’re right. Your primary responsibility as an EMT will always be to care for your patients. But by coming to the rescue at a crime scene and following protocol, you can help the truth be uncovered and play a vital role in assisting victims beyond their medical needs.