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Trauma-ER_Hospital_6510

Jonathan in Houston wrote this comment underneath our post Pro Tip: Call an Ambulance After a Defensive Gun Use:

This is an important topic that almost nobody considers and which we should devote additional attention to here. As important as it is to seek medical attention for yourself, it’s also important to know what you’re getting yourself into . . .

An emergency scene can be more or less routine, but often it can be as chaotic as just about any depiction you’ve seen on T.V. or in the movies. People are coming and going, many are within earshot and eyesight, and privacy can be virtually nonexistent. It can be very difficult controlling yourself, your voice volume, especially your emotions, in the immediate aftermath. Many people instinctively unload on their first responders with a stream of consciousness account of what horror just happened. The mind just needs release as a first stage of processing the gravity and tragedy of whatever just transpired. Well.

You can invoke your rights to silence, to a lawyer and not consent to searches, but you’re still not really in control of yourself and your environs and you do still need to communicate with the EMTs. Things can slip out of your pockets. Your pants could be cut off of your body, revealing things that later constitute evidence. They’ll ask you questions to which you could well respond without thinking. All of this can be overheard and can drive the investigation. And don’t think that so-called doctor-patient confidentiality will protect you, either.

For starters, those laws vary widely by state and courts’ interpretations vary, as well. For some, like Nevada, doctor means exactly that: a doctor. An EMT isn’t a doctor, so no privilege attaches. For some, doctor means those acting under the direction of a doctor, too. Could include an EMT, but then again, not all EMTs, as some are independent and unaffiliated with a hospital or any specific doctor.

Post-DGU, how would you know the corporate and legal affiliations of the EMT? Other states, like New York, spread that privilege pretty widely and include first responders. (Maybe even nonprofessional first responders, such as bystanders providing first aid, but don’t quote me on that. I only have a sketchy source for that part.)

Some states specify that even if there is a doctor-patient privilege that extends to a nurse, paramedic, EMT, or other healthcare provider, who’s working under the direction of a doctor, that patient must actually receive treatment. What specific acts constitute receipt of treatment? Hmmm…..I don’t know. Sounds like a point for lawyers to argue over for a year or more, at your expense.

Regardless, such privilege, even where applicable, extends to information about your medical condition/problem and treatments. It doesn’t apply to you blurting out that you’re glad the mugger you just shot was a minority, because “their kind” have it coming. Not only is there no guarantee of confidentiality, but there’s a guarantee of NO confidentiality, actually, in certain cases. Medical personnel are typically required to notify police of drug-related emergencies and of gunshots, for example.

Every situation is different and it’s impossible to develop a standard plan, but you can be aware of these general principles to help protect yourself. Invoke your rights with the police, and just do the best you can providing information to the emergency medical personnel treating you, without divulging too much about the incident itself unrelated to your medical condition(s).

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48 COMMENTS

    • But if the stupid thing you say is “you’re glad the mugger you just shot was a minority, because “their kind” have it coming” then you deserve to rot in hell.
      Is TTAG becoming an instruction booklet on how to kill minorities and get away with it?
      Farago, surely there are better comments to rehash than this contribution from Johnathan from Houston.

      • Michael, you lack some reading comprehension skills. Seriously, go take a course and stay away from the adults until you figure out what we’re talking about.

        • I copied and pasted that directly from the article. How could I have possibly misunderstood? Maybe you should take a course on not being an asshole..
          He is saying that you should keep your mouth shut because what you say can be used against you. I get that. But if you are no better than the one you shot, I have no sympathy for your troubles.

        • “You deserve to rot in hell,”

          So all racists deserve to die? What a very liberal statement. I’m sure many liberals consider you a racist. Simply because you own a gun.

          • We all die and some deserve damnation. I didn’t say deserve to die. I said deserve to rot in hell. You know, when your day of judgment comes?
            Why are you defending this stupid article?

        • So if I said that white trash POS mugger got what he deserves is ok, but if someone says that POS black gang banging mugger got what he deserved is not ok and considered racist…….Ok here’s a real brain stumper….What if a Black person said that POS muggin bitch ass Nigg gotz what he gotz. And that folks is called double standards!

          • Justin, what’s up my GA Glock friend?
            Do you understand my point? If you say anything derogatory referring to the attacker you just dispatched, that can be considered proof that you may have had a motive beyond self defense, then I believe that what is in your heart is the truth and that truth absolutely should be used against you.
            It doesn’t even have to be race. An old man might have shot a teenager and made a statement, “F***ing punks these days are worthless POSs!” If the evidence of self defense is shaky, and the DA needs something to run with, this statement may get you in a world of hurt. I am sure that is the point of the article, but I want assholes that kill people out of hate to get strung up.
            Now if there is a clear cut case of self defense then nothing you say should matter. Remember this?:
            http://www.thetruthaboutguns.com/2015/01/dean-weingarten/self-defense-tip-dont-talk-reporters/

        • Ok I see your point. I personally don’t dislike or judge anyone before I get to know them. I honestly never think of the color of someones skin, which has been interesting when I say something like go to the clinic and ask for Mike R. and the individual later talks to me and asks “why I didn’t mention he was black…..there were two Mikes working at the clinic”. To which I reply that’s what I said ask for Mike “R.” Well getting back to the point YOU SHOULD SAY NOTHING other then “I’m in need of medical assistance” (Which you should always say even if you don’t) or “I’m don’t mind answering you question but I am very confused and would feel better if I had my lawyer with me”. Lastly….I’ve been told specifically by my lawyer if I was ever in a DGU situation to call 911 and say the following “I NEED HELP, I NEED HELP, my address is XXX, PLEASE COME QUICK and then hang up” When the police arrive say the following and only the following. “That man/woman is trying to kill me, please arrest him/her and protect me.” As explained to me even though you know he/she is dead as a door nail….the DA and PD only have the following statement to use against you and if it goes to court you lawyer can ask the responding officer what did the defendant say when you arrived……A:) He wanted me to arrest the “victim” and asked me to protect him. This will help your lawyer argue you were afraid for your life and you didn’t want to shoot the individual evidenced by your request that someone arrest the “victim” while begging that the officer protect you from the “victim”. If someone broke in to my home at night I don’t want to kill them. That’s why I train and train and them train some more. I’d rather disable the individual with a leg wound or shoulder wound…….But….if that individual raped or murdered a family member I might “disable the individual differently”

          • We are all on the same page. I just didn’t like the (hey racists, keep your mouth shut) implication.
            I would even go so far as to call an ambulance for my attacker. I made that comment a few days ago on another topic.

      • Or… sometimes people blurt out things they don’t mean when under severe shock and stress.

        But broad-brushes are, apparently, the easiest tools to use…. or become.

        • I am critiquing the article as written. The only example given for why you should STFU, is because your racist rantings may emerge. I agree with the sentiment to be careful what you say and whom you say it.
          But how can one in shock, not thinking clearly, all of a sudden come to their senses because of an article they read on TTAG several years before the event.
          My problem with this article that you hard heads don’t get is think of our black friends that read this. Think of the anti trolls that read this. If I worked for Salon, I would take this direct quote from the article and claim that TTAG is teaching their racist followers how to get away with killing minorities. Pretend not to be a racist when talking to first responders.
          That may not have been Johnathan’s intent, maybe he was trying to appeal to what he believes most of us are, but it was definitely the wrong way to make a point.

      • I understand what your getting at, though I feel that the intention behind using that language, was to demonstrate an extreme scenario, rather than providing instruction to racists on how to get away with it.

        TTAG has taken a dim view of racism in the past, and I don’t see any long-standing evidence to suggest otherwise. I interpreted the statement about minorities to be an extreme example of something that would incriminate a person without intending to.

        I think it could have been written with the same effect as “I’m glad he’s dead, he was a criminal and had it coming” and it would have retained the same meaning. But the author wanted an extreme example that wouldn’t invoke a responder disagreeing with the sentiment.

        Just my take.

  1. If possible I’d say get into an ambulance, there will be a Leo riding with you but there will be fewer extra ears around.

    • Word. I’ve been on many ambulance rides. Thankfully not as a patient most of the time. I’ve heard patients babble all sorts of things. Sometimes I’ve had my audio recorder turned on. Sometimes I’ve handcuffed them to the gurney. Sometimes multiple handcuffs, leg restraints, and a spit sock.

      Good article.

      Our audio / visual recording system operates via Bluetooth. Basically, if I can hit my patrol car with a baseball I have recording capability. Sometimes. If the batteries are charged. Other agencies have bodycams of good quality. Some motor(cycle) cops have bought personal body cams. Plus there are iPhones and such.

      Regardless, EMTs, paramedics, and firefighters, as well as LEOs riding with you can all be subpoena as witnesses in a civil or criminal proceeding. I have several fatal incidents I’ve personally investigated where there have been more than 50 witnesses attached to an incident.

      When in doubt, lawyer up and STFU.

      • Brings to mind a line from an old Ron White bit where he says (because he was very drunk) that “I had to right to keep silent, but not the ability.”

        As someone with a significant medical history, you can and will say ANYTHING when the right drug hits your system. Hopefully, if I am ever in one of these situations, my wife (who is also an attorney) will be beside me; she has long practice gently keeping her hand over my mouth to keep me from spouting profanity when I am wheeled down a hospital hallway.

        Agree. Good article.

      • “Our audio / visual recording system operates via Bluetooth. Basically, if I can hit my patrol car with a baseball I have recording capability.” This is an example where engineers should get out in the field more. Why not just use a switch? 😉

        Sorry, couldn’t resist. This is an excellent addendum to the original piece.

    • Having an LEO with you in the medic is the exception rather than the rule – usually if you are violent. Otherwise they follow or come later, or transport you in their patrol car if possible.

  2. What happens to your pistol if you need to go for a ride to the ER, in this scenario or just an average car wreck?

    • As a paramedic in a major system where RF lives, our policy is to secure your weapon and turn it over to law enforcement. If it’s not evidence my (unofficial) understanding is that they return it to you at your request. No guns go into the hospital under any circumstances.

        • That’s a stupid comment. He’s saying they don’t transport and store firearms for patients who are temporarily unable to do so; not advocating hospitals as gun-free zones. I’m guessing that you knew that and just couldn’t resist.

        • “No guns go into the hospital under any circumstances.” is a remarkably broad statement on its face.

          I understand he may not have meant what he wrote, but it is what he wrote.

      • The firearm, if not used in a homicide, will be booked into property at the office having jurisdiction over the incident. If the serial number is clear and the firearm and its ownership were not in violation of local or state laws, the firearm can be picked up by the appropriate owner at the LEO office during business hours. The owner should be given an evidence receipt describing the article(s) take as soon as practicable. The owner may have to coordinate with the appropriate evidence officer and his/her alternate or the area commander in order to schedule a pick up time.

        The firearm and ammunition may be returned on separate occasions.

        If you were in violation of city or state law, better SHTF and get a good lawyer.

        Note – I’m currently studying our Department’s firearms manual. Most agencies will have policies pretty similar to this – at least in CA.

        Also CA cops can take guns into hospitals, provided they are not in the jail portion.

    • Well, when I accidentally stuck a fork through my wrist and had to take a ride to the ER the paramedic secured my weapon and gave it to my mother (we were out to lunch when the accident happened). Then again, this was in a rural Washington town of less than 2,500.

  3. I was an EMT before becoming an Emergency RN. That covers well over 30 years. To keep it short, we came to help you, and your cooperation goes a long way. I’m very busy, I count on remembering nothing, so all that matters is what I put in my notes. I might quote you to describe the all important mechanism of injury, but beyond that it’s a matter of, if you say something that sounds profoundly important. “Patient states he was struck on head with a dead cat,” “patient states he picked a bad day to quit bath salts.” Hope this helps.

    • Addendum: I spent a lot of time trying to get patients to STFU and not talk their way INTO jail. All those years and the 2 most common things I remember patients saying are “I only had 2 beers,” and “I have no idea how that got in there!”

  4. While all the cameras and recording things are becoming pretty ubiquitous, so it is more and more important to be careful what you say, the idea that the EMT or the nurse, etc. will remember every word spoken by a delirious patient is kind of silly, actually. As Paul said, we are really happy when we can make any sense out of what a patient tells us about their history or condition.

    You do carry a card with your allergies and blood type, don’t you? Good to add anything else that might mean the difference between life and death.

    If you are prone to make outrageous racist and macho pronouncements at any time, you might want to give it some thought… What do you think you’d say if you were that stressed, strung out on adrenalin and so forth? In any case, trust me, you won’t have much control over it at the time – so don’t count on being able to control that much.

    I’m going to do what it takes to stay alive, and worry about the cops and the courts when and if they become an issue.

    • “You do carry a card with your allergies and blood type, don’t you?” I’ve thought about this, partially because I don’t know my blood type and partially because of the blood type patches that the tacticool guys wear… is there really any time that a patient-suppled blood type is actually trusted for anything? In other words, what is a situation in which actually knowing your blood type would make any difference?

      • Knowing your blood type isn’t as essential as it once might have been, though it can’t hurt to know. The hospital would type and match your blood before giving any whole blood anyway, just to be sure.

        But having a card detailing your allergies and other serious medical history is very important. I know from long experience that many supposed medical “errors” are the result of a lack of such information, especially in the emergency setting. Doctors are not clairvoyant, unfortunately, and the human body is a wonderously complex thing. By providing this basic information, you help yourself and the doctors.

  5. You’re not free to speak your mind until clear of all people except those you trust and maybe not even then. If you made any mistakes no matter how small they will be amplified one thousand times. See the Zimmerman case for examples.
    EMTs will be interviewed for sure. If you are aeriously injured and given pain pills you might get away with diminished ability or similar.
    It really comes down to the climate. Cops out to get you or the perp? DA a gun supporter or not? Lots of variables there

  6. Greg Allman’s autobiography is an interesting read. In it he comments on telling the truth about whether or not you’ve been messin’ around with other women. His advice: “shut the f**k up!”. That seems to apply here as well. State bureaucrats at all levels have become gate-keepers and that means that, whenever you deal with them, it’s best to assume you are in a adversarial relationship with someone who most likely doesn’t have your best interests in mind. So: Shut. The. F**K. Up.

  7. Unless you have Tourette’s Syndrome, the best way to not blurt something out is not to think it. The reason a jury would take exception to you blurting out you were glad the mugger you just shot was a minority, because “their kind” have it coming, is because the presumption would be that’s your real attitude and you just let it loose in a moment of weakness. I’d say they might be right.

    I would not be SORRY, but I would truly regret that I was forced to shoot anyone, no matter what race creed or color they were. And I would never think they deserved it, just that they created a situation that it was either them or me. That thought process should keep me from blurting anything out that I shouldn’t.

    • “Your beliefs become your thoughts,
      Your thoughts become your words,
      Your words become your actions,
      Your actions become your habits,
      Your habits become your values,
      Your values become your destiny.”

      Gandhi

  8. when I had my motorcycle accident the first thing I did when the officer got there was have him secure my handguns he gave them to my family when they got there

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  10. I truly believe that Michael in GA is the only one in here that is Racist. Only people like him that go off at the mouth about what he feel’s is wrong is making up for how he really feel’s to get a notch on that, ” I LOVE ALL PEOPLE” BS.

    • Race was first brought up in the article and I am the only one pointing it out. Your statement however makes no sense whatsoever.
      I didn’t call anyone a racist for that matter. I think the one line in the article brought the whole thing down. Why can’t you disagree with me without inflammatory remarks?

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