True Paramedic Stories Scoop and Run

By David Smitty Smith

aramedic crews encounter situations beyond the scope of field medical work. In these situations they use the SST protocol which is, spinal stabilization and transport known in the field as Scoop and Run. Dont know what to do? Cant do anything? SST! Medics dont often talk to outsiders about the times they get in over their heads, or when shit hits the fan causing them to scoop up the patient and run to the ER. However Murphy rules, and things often go wrong. As one of the better ER docs once told me, why do you think th ey c a l l i t e m e rg e n c y medicine? My objective in writing this column is to share some of the experiences that have shaped me as a paramedic, a martial artist and as a person. I cannot recall all the times my Judo training saved my partner and me. Rule number one, the prime directive of emergency care, is, do no further harm. This is one of the most memorable times I violated that directive. My partner, Joe and I were dispatched to a violent 5150that is a psych patient to be taken to County Mental Health. We arrived first before the sheriffs department and the local volunteer firemen, which on a violent call always presents a problem. No matter who is there, you are, the government, and youre, here to help. Upon arrival we found a huge 270 lb. almost naked man running around in the front yard in verbal combat with an unseen foe. An invisible man. Sometimes he won, sometimes he lost, we judged from the gyrations. I kept an eye on the guy while Joe interviewed the family. He just lost it man, one relative told my partner. Meanwhile I tried to coax the guy into the ambulance, to no avail. It became me and the invisible man against him. Hey Joe, get the gurney and some Kerlix, I told my partner, We are going to have to restrain him. Okay, he replies and heads off to the rig. Just about then the guy tries to bolt off. I intercept him by getting right in his face. Man this SOB is huge, I think to myself looking up at his face and straining my neck to look at him shoulder-to-shoulder. He stands there like Superman, arms akimbo on his hips. Before I have the chance to dwell more on the size of the guys biceps, he roars and throws a haymaker at my head with a right hamhock the textbook would label a fist. I block with an open hand and quell the temptation to smash his face with my palm. Instead, I notice his left arm, at his waist, still with his elbow bent out arms akimbo like Superman. I hook his bent arm, and turn it into what is called the hammerlock, bending his arm behind his back. Then I slam it on tight for all I am worth. I have this SOB now, I think to myself as he struggles but cant free himself from my control. Then the guy gets real horsy, bucking up like a bronco with me on him. Hurry up Joe, I dont know how long I can hold this guy, I yell. Then, like a flash, he stands straight up, right a g a i n s t t h e a r m l o c k . Crackhis arm breaks just above the elbow. I step

back shocked and surprised. He looks at me then takes another swing at me, but this time with the broken arm! It swings at the shoulder limp and unnatural. I easily avoid it but barely hold down the desire to puke all over the guy. His arm flails at inhuman angles like a wet noodle. Then he swings the good one, and I pass it and get behind him sinking in a good old naked choke my arm wrapped around his neck. Joe arrived just as the guy blacked out. We tossed hi m on the gur ney and restrained him with the Kerlix. Then we splinted his badly broken arm. What happened Joe asked. Goddamned PCP is what happened, that armlock didnt hurt him a bit, neither did that broken arm, well at least not for now. That was when I first realized there are two rules in the paramedic prime directives: Rule 1) Do not allow yourself or other care providers to be harmed while attempting to help others. Rule 2) Do no further harm to the patient, as long as they dont violate rule number one.
David Smitty Smith, a retired paramedic, works in the EMS field in Texas, California and Nevada. He instructs paramedics, nurses and doctors in advanced cardiac life support. He spent a tour in the Air Force as a security police law enforcement officer. Smitty has 30 years of martial arts experience, is a fourth degree black belt in Judo, holds a Bronze Medal from the 1996 Senior Nationals Masters Championships, and works as an SFC instructor currently in the San Francisco Bay Area. (510) 261-1896. December 2000 / January 2001 23