PULSE Magazine | November/December 2018 Issue

The efficacy of the techniques and the easy appli- cation to the EMS work environment. When Andre and I were researching this project our end goal was to have techniques and a methodology that worked and was effective in our environment, the back of an ambulance, one that we could pressure test under duress, did not com- promise patient or provider safety, was easy to learn and employ, and was usable by most any provider regardless of weight, size, gender, and ability as well having ambidextrous applicability. But especially the pressure tested issue! Most self defense systems and techniques are taught as both some kind of pain compliance and, or learned gross motor skills and are scenario and situation dependent such as getting out of head- lock or bear hug. These moves not only require repetitive drilling once learned correctly, but again are entirely situation dependent. We felt that avoiding the headlock or bear hug for example by seeing, interpreting and acting on the pre fight contact cues to move away from danger would have a much higher amount of efficacy than teach- ing someone first how to be in a headlock or bear hug then getting out. I realize that seems very simplistic but think of most any self defense train- ing you've received. Were you taught to detect and avoid danger or did you learn what to do if some- one put you in a specific hold? Do you still remember the moves if that was the case? While getting out of headlock or bear hug have a valuable place in self-defense, for what we do as EMS professionals, these techniques not only rarely occur but must be drilled repeatedly to maintain competence. Further, most use of force violations occur because a technique that was taught and drilled on a compliant training partner rarely if ever works on an uncooperative and com- bative person resisting with all their strength. When a technique is applied to an actual high stress, high intensity situation where a person is combative and actively fighting and that technique isn't working, the natural human tendency is to

apply more strength, more power, and go to baser instincts of striking when the technique is ineffec- tive. Also it's noteworthy to mention here to never let ego or pride dictate your actions in any hostile or violent encounter. The risk and implications of allowing this to occur are all bad. Real violence looks nothing like the movies and mutual combat is not what routinely occurs. Sudden violence is just that. Attackers look for the element of surprise and act impulsively. When speaking of use of force, especially in regards to First Responders, force must parallel danger. You must apply the minimal use of any technique to gain and maintain positional dominance. Striking or kicking a patient should be an absolute last ditch effort where a provider truly fears for their life in a violent encounter. Again this shows the need for us as a profession to better define not only what constitutes, but what separates a patient from an assailant. Spear teaches that in any violent confrontation or fight, there are actually three fights. The first is the realization that the situation could turn violent. This is an emotional attack. Your heart rate increases with the adrenalin spike you feel and your body begins the pathophysiology of fight or flight. The second is the actual fight itself. When the violence occurs. The third is the fight after the fight, the confrontation with your supervisor, the department, and even the judicial system possibly. You must be able to articulate why and how the actions you took were necessary. If the force you applied does not parallel the danger you faced you can be held liable for damages and injury as well as your employer if you're on duty. In this day and age of cell phones and videos going viral quickly, the court of public opinion can carry a lot of weight. IN ANY VIOLENT CONFRONTATION OR FIGHT, THERE ARE ACTUALLY THREE FIGHTS

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