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Your trauma shears are a potential weapon

There is no reason why trauma scissors, Leatherman tools and folding knives need to be carried where potentially violent patients can grab them

Cindy (not her real name) was transporting the passenger from a single car rollover, a drunken 14-year-old girl with neck and belly pain.

The girl freaked out in the middle of transport, ripping off the O2 cannula and tape holding her head to the board while Cindy tried to calm her and keep her immobilized. She grabbed Cindy’s pink handled trauma scissors out of the thigh pocket of her EMS pants and stabbed her in the side. Cindy survived, lost her right kidney, and now works as a dispatcher.

A few years ago a paramedic in Oakland nearly lost an ear when an unruly drunk snatched the trauma scissors off the action wall in the ambulance and started snipping.

I was given my first pair of penny cutters when I graduated from EMT school. There’s nothing that says “I’m a cool EMS provider” quite like the handle of a pair of trauma scissors poking out of a belt holster or the side pocket of stylish EMS pants. Some of them have pink handles, others are big enough that they could be used to go toe-to-toe with a Samurai.

Ask your average EMS provider why she or he carries trauma sheers in such an easy access location and you’re likely to hear things like, “to cut the seatbelt quickly so I can pull someone out of a burning car” or, “our trauma protocols say we need to strip and flip before we load. With these babies I can get somebody naked faster than a schnauzer can down a meatball.”

There’s no doubt that a good pair of scissors can be a useful EMS tool. So can a blood pressure cuff, a KED, and a ring cutter, but you don’t usually see folks carrying these on their belts. In reality there is no reason why trauma scissors, Leatherman tools, and folding knives need to be carried where potentially violent patients can grab them. They can be left in the trauma bag or carried in a pocket in such a way that they can’t be seen.

You’ll get different reactions when you point out the danger of providing weapons to potentially violent people. Medics may react in a variety of ways to you pointing out that they’re posing an unnecessary risk to themselves, their partners, and their patients. Most people will be grateful and will relocate their unintentional weapon to a pocket, trauma bag, a place where it can’t be seen.

Others may swagger a bit and proclaim something like, “I’d like to see someone try to take my scissors” or, “I’ve been wearing these on by belt for 22 years and no one has grabbed them yet.” If you get this response, then you might want to point out that according to an FBI analysis eight percent of police officers killed in the line of duty were killed with their own firearm. Chances are good that every one of those dead law enforcement professionals has not had their gun taken from them prior to the time they were killed. Officers are trained to retain their weapons, but the course on keeping scissors away from violent patients seems to be missing from our national curricula.

Please keep your tools hidden and encourage the people you work with to do the same. The life you save may be your own.

Mike Taigman uses more than four decades of experience to help EMS leaders and field personnel improve the care/service they provide to patients and their communities. Mike is the Improvement Guide for FirstWatch, a company which provides near-real time monitoring and analysis of data along with performance improvement coaching for EMS agencies.

He teaches Improvement Science in the Master’s in Healthcare Administration and Interprofessional Leadership at the University of California San Francisco and the Emergency Health Services Management Graduate Program at the University of Maryland Baltimore County. He’s the author of “Super-Charge Your Stress Management in the Age of COVID-19.” Contact him at mtaigman@firstwatch.net.