By DAVID MILLS
I was first introduced to the fire service as a martial artist. At the time, Eagle River (CO) Fire Protection District Chief Charlie Moore was taking classes at a local martial arts school where I was an assistant instructor. While there, he apparently recognized some quality in me which he thought might make me a good fit as a firefighter. That is how I began my career as a proud member of the fire service. My background has helped me see firefighting from a martial artist’s perspective. In many ways, firefighting has made me a better martial artist and, likewise, my martial arts training has made me a better firefighter.
Martial arts has an ancient and proud tradition of rigorous training and preparation. It requires-from those who choose to follow its path-fierce loyalty, discipline, and commitment. For those who are willing to pay the price, the rewards are deep and vast. As a martial arts and fire/emergency medical services (EMS) instructor, I have noticed clear parallels between both traditions; at the heart of each lies a similar value system and approach to life. I believe the line between both traditions has begun to fade.
Since I began my journey as a firefighter, I have attempted to identify some way I might be able to share my martial arts experiences with other firefighters to possibly help them do their jobs better and more safely. For years, I missed the obvious. It was not until my captain, Ted Lilley, knowing my background, asked me a couple of years ago if I would be interested in teaching our department some basic self-defense techniques. This request arose following an incident where several of our firefighters were attacked during an “unknown medical” call by an adult female. The patient was suffering from a condition known as “excited delirium.” The class was effective and received high praise. It was then I realized how desperately the fire service needed self-defense training.
Several years before my “epiphany,” the National Fallen Firefighters Foundation (NFFF) recognized the need for “national protocols for response to violent incidents” in Life Safety Initiative #12. In the NFFF’s Final Report, published in October 2012, it presented a preliminary checklist that outlined what to do if confronted with violence. This common-sense checklist recommends that if you can avoid violence then, obviously, avoid it until law enforcement can bring it under control. The Final Report goes on to suggest that if you are confronted by violence and you cannot safely remove yourself, then you should defend yourself with “reasonable force.” The Final Report also mentions the Occupational Safety and Health Administration (OSHA) General Duty Clause, which suggests that fire departments may have a legal obligation to provide workplace violence training and engineering and administrative controls when the potential for workplace violence exists. It is glaringly obvious that the potential for workplace violence exists for firefighters and emergency medical technicians (EMTs).
BREAKING GROUND
Administrative buy-in for comprehensive self-defense training has been slow; this may be because of fear of civil liability. Many fire administrators may feel that if they provide self-defense training, they are giving their personnel the “green light” to use force on the people they are sworn to protect, and that is likely an uncomfortable feeling. They may also feel that self-defense training goes outside of the traditional role as firefighters, believing that it’s a police officer’s job. As indicated by the OSHA General Duty Clause, there are likely greater liability issues associated with neglecting to train firefighters on how to deal with violence. If we want firefighters to make good choices, they must understand their options, the standards to which they are held, and how to select the best available option based on the situation at hand. Most of us understand this. If it is true in every other aspect of our job, then it is true in regard to violence.
Thinking back to my initial civil service interview for my current position as a career firefighter, I recall my martial arts training being called into question. The interview panel members speculated that my training may make me more prone to solving conflicts with violence. Although I recall that interview, I find it ironic that martial arts training has proven to be my single greatest asset as a firefighter/paramedic and fire/EMS instructor.
There are an estimated 700,000 assaults on paramedics and EMTs annually in the U.S.1 Because of the nature of their job, firefighters are much more likely to encounter violence than the average person. The question you need to ask is, Are we any better prepared to deal with violence than the average person? That answer should be a resounding YES. If it is not, then, as Gordon Graham, a leading expert in risk management, says, “That is a problem lying in wait.”
There is widespread evidence that the majority of firefighters and EMTs can expect to be assaulted at some point in their careers. However, the severity and timing of the assault are difficult to determine.
Most fire and EMS policies regarding responses to violence are for responses to known violence. This is like writing a garage fire standard operating guideline and trying to apply it to all house fires. It simply does not prepare you to deal with the full scope of the hazards and conditions you may face. Each department or agency needs a comprehensive policy on dealing with violence that includes the right for its personnel to defend themselves and steps to identify, avoid, or deescalate emerging threats.
MANAGING VIOLENT PATIENTS VS. SELF-DEFENSE
It is important to draw a clear distinction between violent patient management (VPM) and firefighter/EMT self-defense. During VPM, the patient/health care provider relationship remains intact. VPM should be viewed as a critical part of our treatment plan for patients who, as a result of their medical condition or traumatic injury, are combative. For instance, you apply oxygen on patients who have difficulty breathing; you establish intravenous (IV) access for patients who need IV medications and fluids; and, likewise, you control and restrain patients who are a threat to themselves or us. Establishing control of patients in the safest manner possible and effectively restraining them to perform necessary medical interventions and transport are critical components of patient care. If performed ineffectively, patient restraint procedures could lead to further patient and personnel injuries. In addition, the ineffective use of force will likely lead to an escalation of violence, suddenly forcing health care providers from a patient care situation into a self-defense situation. A self-defense situation exists when a firefighter/EMT believes he is in danger, in which case his mindset and objectives change from safely rendering patient care to getting home safely.
SITUATIONAL AWARENESS
My martial arts instructor, Sensei James Lee, taught me early in my training, “The best block in the world is not being there.” Like everything in the martial arts, that lesson has deeper levels of application, levels that are obvious for firefighters. It is pretty simple: When a roof collapses, a floor gives away, a room flashes, or violence erupts, don’t be there. Our greatest defense against life-threatening hazards from fire or violence is not being there when they happen. The ability to recognize or anticipate an impending attack or a sudden worsening situation and make sure you are “not there” is essential.
Situational awareness is an essential concept for both firefighters and martial artists. As a firefighter, I understand it as a deliberate, ongoing process of perception and evaluation to make informed decisions regarding an incident. As a martial artist, it is not just seeing what is there but seeing what could be there, not just seeing what is happening but what could happen, and having a plan. For a martial artist and a firefighter, the world is full of “what ifs.” It is time for firefighters to start asking themselves, “What if I am suddenly attacked?”
SCENE SIZE-UP
Whether responding to a structure fire, an unknown medical, or a motor vehicle collision, the initial scene size-up is critically important to establishing situational awareness. You must perceive-with your senses-what is occurring and analyze and evaluate that information to make decisions. You must get the “big picture.” However, many of us are terribly prone to tunnel vision at this stage and throughout the response. Anxiety can cause perceptual and cognitive decline, inhibiting our ability to perceive and evaluate information. Also, the brain is prone to selective inattention; when it tunes into something, it tends to tune out other things. By establishing and maintaining big picture awareness throughout any emergency operation, you can better ensure safety and effectiveness. Big picture awareness will come from effective incident oversight. From a self-defense perspective, effective incident oversight allows us to recognize emerging threats, anticipate them before they happen, possibly diffuse an escalating threat, or remove ourselves from a situation that is becoming dangerous.
From a tactical perspective, there are two types of personnel on an emergency scene: “task-dedicated” and “strategy-dedicated.” A task-dedicated individual has hands on the patient, the handline, and the tool and is inescapably prone to “tunnel vision.” Therefore, he cannot be expected to maintain big picture awareness. A strategy-dedicated person is “hands off”; he is ideally located remote from the operation, maintaining big picture awareness, and thinking two or three moves ahead. He is plan-dedicated and responsible for the overall cohesiveness of the response. He is also in the best position to recognize an emerging threat; give the order to withdraw when indicated; or coordinate a team-based response to violence, if necessary.
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