The fourth crime scene I'd like to address is the assault (it should really be called battery, but that's a whole different blog post). Assault calls can actually be shootings or stabbings, but typically they come in much more innocently. While shootings and stabbings are definitely assaults, you'll typically be looking at a hand-to-hand combat situation or a blunt trauma injury. Like shootings and stabbings, your patient's (and bystanders') emotions will probably be running high and there are a lot of issues to consider.
Once again, stage until the scene is as secure as it can be. Enter carefully and preserve as much evidence as possible. Search for weapons and all that fun stuff.
So as you scan for evidence and evaluate the scene, approach the patient and conduct the initial assessment. Assaults frequently involve the use of alcohol, so you may need to brush up on your Drunkenese to conduct a thorough assessment. Also keep in mind that the story you get may not necessarily be the truth, as the assailant and victim know each other much of the time. Especially in the case of domestic violence or family fights, the victim may downplay their injuries in an attempt to lessen the consequences for the perpetrator.
Shootings and stabbings are felonies and the detectives will conduct a very thorough investigation. Most assaults are misdemeanors, though, and the investigation will likely be conducted by a uniformed officer. The officer also has a great deal of discretion when dealing with misdemeanors, so the attitude test will have a huge impact on how things go down arrest-wise. There are three big exceptions here: the first is domestic violence, as many jurisdictions have a mandatory arrest provision; the second is aggravated assaults, which can often be charged as felonies; and the third is sexual assaults.
Many patients know that their version of the story can make the perpetrator's consequences greater or lesser, and they may change their story to some degree when giving a statement to the police. They often will then give a slightly more honest account to fire/EMS if the cops are out of earshot.
The type of weapon is an important piece of your puzzle. In my Nailed It!
post, I quickly learned that a 2x4 can easily be modified to inflict
grievous injuries, so it always pays off to take a second and take a
look at the weapon if you can. Again, pictures can paint a great picture
for the docs and nurses at the emergency department, but don't get
yourself in trouble if your employer prohibits them. Also, don't take
the weapon from the scene.
Speaking of pictures, the law
enforcement officers on scene will likely want to take a picture of the
patient's injuries prior to treatment and transport, and as long as that
doesn't negatively impact the patient it's best to accommodate that.
The patient's injuries may be very superficial, and the pictures
that the cops want to take could very well be the only physical evidence
that the prosecution will have available if the case makes it to trial.
In a 'simple' assault, the mechanism of injury is typically a hand
inflicting a punch or a foot inflicting a kick. Sometimes there will be bites. There could also be a
shove, resulting in contact with a wall, furniture, the floor or the
ground. Even a single blow can cause devastating injury, so be
sure to be thorough in your assessments.
In these cases, you'll want to determine the size and physical capabilities of the assailant. A 5'9" 170lb MMA fighter possesses a much greater potential for inflicting serious injury than a 5'4" 170lb housewife, so try to get a well informed idea of the aggressor's potential to cause injury.
In the aggravated assaults/assault with a deadly weapon/assault with intent to cause great bodily harm calls, the greater injury/potential for injury allows for felony charges to be filed, and weapons are typically involved.
The weapons in more serious cases can range from brass knuckles and beer bottles to baseball bats and lamps. Furniture and even vehicles can be weapons, too. People can be very creative when it comes to hurting each other.
Just because there aren't bullet holes in the patient's clothing doesn't mean there's no evidence potential. Ripped or torn clothing can still be important evidence, and in the event that you need to remove clothing to treat the patient, do so very careful and avoid cutting through the rips. Don't dispose of the removed clothing.
Clothing will be extremely important evidence in the case of sexual assaults, so do your best to minimize any disturbance of the clothes. If the patient is wearing the same clothes that he or she was assaulted in, there is a very high probability that valuable forensic evidence is on the clothing. While the patient will probably want nothing more than to shower and put on fresh clothes, such actions will destroy a huge amount of that evidence. Do your best to attend to the patients physical and emotional needs, and try to convince them to remain in the clothing.
Especially in the case of head injuries, the patient may be altered or otherwise combative. Remember too that the patient might not be an innocent victim - they could be the perpetrator. Watch their
hands, and be cautious of weapons.
Again, the patient may be suffering from
multiple wounds, so the importance of a thorough physical exam cannot be stressed enough.
My earlier points about patient statements being important evidence still apply, so be sure to accurately document the patient's account of the circumstances, perpetrator and weapon, if applicable. Document
everything else thoroughly as well.
The common theme throughout the CSI: Fairview series has been, and will continue to be, this: treat your patient appropriately and professionally while
maintaining vigilant situational awareness, preserving the evidence and
thoroughly documenting the circumstances.
Put it into practice on each and every run, and it'll soon become second nature.
If you have anything to add, I welcome your input.
Be safe!
Traumatic License - a peek inside the crazy world of pre-hospital medicine in Fairview, USA
Saturday, December 10, 2011
Monday, December 5, 2011
I Really Hate Drunk Drivers...
Here's a copy of my incident report about why I was late to work the other day. It was my regular day off, but I agreed to come in to cover for one of the other guys. He got super bent out of shape about me being 8 minutes late. Good times.
* * * * *
On the afternoon of 30 November, 2011 at approximately 1308 I was driving from my personal residence to my assigned shift at Station 3. I was headed northbound on 88 just south of Greenville in the #2 (slow) lane. A small silver Toyota passed me at approximately 85-90 mph. The vehicle began swerving into the center divider and #2 lane, and slowed abruptly about 1/4 mile ahead of me, nearly having multiple collisions. I slowed my vehicle in anticipation of further erratic driving behavior and matched my speed to the other vehicle.
I then observed the driver and passenger hitting each other, which was causing the vehicle to swerve and brake in an even more erratic nature than before. I was unable to determine whether the two were assaulting each other with malicious intent or engaged in horseplay, but either way the situation created an extreme and unacceptable safety hazard to the two of them, the back seat passenger, myself and all the other motorists in the area. The driver braked hard and cut back into my lane, and I was able to obtain the vehicle's license plate number. The driver sped up quickly, pulled to the shoulder and nearly stopped. He then accelerated quickly back to 85-90 mph, rounded a bend and disappeared from my view.
At 1309 I called Greenville PD's dispatch to advise them of the situation. They didn't have any units in position to initiate a traffic stop and transferred me to the Highway Patrol. I was on the phone with the SHP dispatcher for 4 minutes and provided a complete description of the vehicle and the circumstances, as well as the vehicle's last known direction of travel and speed. I advised her of my current location and she told me that she would update the units in the area.
I continued northbound toward Fairview and did not see the vehicle again as I passed through Winchester and approached Georgetown.
At 1319 I received a call back from the state police. The dispatcher asked me if I still had the suspect vehicle in sight, and I told her that I did not. She told me that she had a trooper preparing to initiate an enforcement stop on the vehicle. The dispatcher requested that I stop in a safe position behind his patrol vehicle and wait for him to make contact with me and obtain a statement. I gave her a description of my vehicle and told her I would park in a safe place when I came upon the traffic stop.
I continued northbound through Georgetown and saw traffic begin to slow on the south side of Meadowbrook. At 1328 I rounded a bend just north of the Fairmont Rd exit and observed multiple patrol vehicles on the shoulder with their emergency lights activated. I got closer and saw a silver car in front of the patrol cars, so I slowed down, signaled my intentions and came to a stop approximately 30 feet to the rear of the last squad car.
I sat in the vehicle for about 15 minutes before a trooper approached my vehicle. I identified myself and gave him a detailed account of what I saw. He took down my information and telephone number, and told me that he suspected that the driver was driving under the influence. He thanked me for the call and advised me to drive safe and have a good shift at work.
I left the scene and continued into Fairview to start my shift.
After further followup with the dispatch center, I determined that the trooper arrested the driver on suspicion of driving under the influence.
* * * * *
Fortunately I was only a few minutes late, and while the boss knew I was going to be a little late, the guy I was relieving had been having a lot of attendance issues himself lately. The boss just wanted me to have the report ready in case the other guy complained to headquarters. I hate being late and pride myself on my attendance, but I figure this was a great reason to show up late. I have no idea why the guy was drunk at 1 in the afternoon or why he and the passenger were smacking each other, but I'm glad the driver ended up in jail before he hurt anyone...
Sunday, December 4, 2011
The Ride of a Lifetime...
or, the Excellent Embraer Excursion...
Back in September I heard about a newish company based on the West Coast called JetSuite.
In plain English, that basically means it's a top-notch jet charter firm that has a growing fleet of brand new luxuriously appointed 4-passenger jets.
The ARGUS Platinum rating is awarded to aircraft operators that demonstrate the highest level of aviation industry best practices throughout all levels of the organization, and JetSuite earned it very quickly. Looking at the folks in charge, though, it's easy to see why.
JetSuite's pedigree is very impressive - Alex Wilcox, JetSuite's CEO, brings decades of experience gained at Southwest, Virgin Atlantic and JetBlue to a perhaps not-so-predictable destination: the private charter world. Mr. Wilcox is in good company, too - Tony Hsieh of Zappos.com and Gary Waldman of SideStep.com (now Kayak.com) are just two of JetSuite's talented executives.
Right about now you may be wondering what happened to the normal Traumatic License content, but don't worry - it'll all make sense in a second.
I love to fly. I love everything about flying. Whether I'm in a huge commercial jetliner, a small private plane, a helicopter or even a blimp, I'm happiest when I'm off the ground. So when I read an article about JetSuite around Labor Day, my interest was piqued.
While at first glance JetSuite might seem to be like every other charter operator out there, there's one distinct difference: affordability. JetSuite offers an on-demand charter product that, while still expensive by coach class commercial airline standards, is similar to what you might expect to pay for first class seating. They've upped the ante considerably, though, with their SuiteShares, SuiteSavers and SuiteDeals. A one way SuiteSaver flight on a 4 seat private jet can be had for $999 - $250 a person - and the SuiteDeals allow you to steal a flight for just $499. The SuiteDeals are posted between 4pm and 6pm Pacific Time through their Facebook and Twitter pages, and that $125 per seat price point is impossible to beat.
Now, the SuiteDeals are only available the day before the flight, and the route is non-negotiable. The $499 covers all 4 seats, your luggage, your snacks and beverages - everything. With the 7.5% federal excise tax, you're looking at $536.43 out the door for 4 adults. You can even bring a child on your lap or your pet in the cabin, and the luggage compartment easily accommodates skis or golf bags. If a given flight works for you, it's the best possible way to fly. While Fairview isn't typically served by JetSuite, I've kept an eye out for the last few months hoping a SuiteDeal would come up for me.
And wouldn't you know it? One finally did.
I was visiting my dad in Pleasantville a couple weeks before Thanksgiving. As an AWESOME recognition of our veterans' service and sacrifice to the country, JetSuite offered FREE flights to veterans. My dad retired from the Air Force, so the potential for a free ride was definitely there.
I not-so-patiently waited for the Veteran's Day SuiteDeals to be posted, and when one looked like it would work out with my schedule, I started to get excited. I talked to my dad to see if he was up for a crazy adventure the next day, and he said he was intrigued. I withheld details, but since he didn't have any plans for the day I got to work.
I checked out Google and looked at cab fares from the airport to the Amtrak station, and went to Amtrak to figure out their schedule and fares for a ride home. The Amtrak fare turned out to be about $80 and the cab was gonna be $50ish. So this excursion could be had for the low, low price of $130, plus food for the day. I figured around $200 would get us decent food and a great story to tell, and I got in touch with the JetSuite folks to try to make something work.
I followed the SuiteDeal request process, and when I called in to talk to them about it everything went very smoothly. I had a great conversation with Lauren, one of JetSuite's amazing Client Services professionals, and we worked out the details of the flight. She emailed me a quote, I emailed her a picture of my dad's military ID, and I was suddenly one of the 1% (aviation industry analysts report that less than 1% of Americans have traveled by private jet, and it's JetSuite's aim to triple or quadruple that)
I then got an email with an FAQ that explained everything in detail. It was quickly followed up with an email from Robert, who gave me the particulars for the two FBOs we'd be using at the origin and destination airports. FBOs are the fixed base operators - they're often the place you'd go for a flight lesson or hangar rental, but in this case they were both very upscale private jet terminals. Robert also checked on my need for ground transportation, but since I figured I'd be hailing a cab I told him I was squared away.
With the flight booked and the address of the FBO in hand, I called my dad to set up a time to meet up for breakfast. I filled him in on what exactly my plans for us the following day were, and I went to bed feeling not-unlike a kid on Christmas Eve.
The alarm found me reasonably well rested 7 hours later, and I went through my morning routine. I figured comfort and respectability were going to be important, so I opted for khakis and a polo shirt. I picked my dad up and saw that he had the same idea - business casual was the theme of the day. I asked him where he wanted to eat and he threw a curveball my way. He really just wanted wanted fast food and coffee, so we ate a quick breakfast and headed to the airport.
Since we didn't have a normal sit down meal, we arrived at the airport about an hour prior to our scheduled departure time. I assumed we'd read magazines or something in the FBO's lounge since we were early, but all thoughts of reading disappeared when we passed the commercial terminal and approached the FBO.
I saw a number of aircraft on the ramp, ranging from little Cessnas and Mooneys to a helicopter, a Lear or two, and even a Gulfstream V.
But there amid the group was a sleek and beautiful Phenom. The red stripe was unmistakable, and my anticipation swelled. I pointed it out to my dad and told him that it was our plane - at least for the morning.
I parked about 50 feet from the FBO's front door and we walked in. It was pretty amazing. My previous FBO experience was all either greasy hangars that smell like AvGas or small operations where we'd wait for a medevac plane to come in... in other words, much more utilitarian than this. My dad went to grab a glass of water while I walked to the reception area and told the pleasant woman behind the desk that we were there for the JetSuite flight.
She asked us to wait a moment while she invited the flight crew to meet us. The pilots walked out of the pilot's lounge within seconds and introduced themselves to me. They were both very friendly and professional, and by all appearances were the most competent pilots on the planet. They wore black slacks and black polos, which was a nice touch - all the other pilots milling around looked like your typical commercial pilots. Commercial pilots look respectable in their white shirts with the gold epaulets and all, but the JetSuite look was sharp AND stood out from the rest.
Martin spent a few minutes getting to know us while Carey prepped the aircraft. We were an hour early, so I'm sure if we had showed up 15 minutes prior to departure it would have all been done by the time we got there. I think it worked out better this way, though, as Martin is a very friendly guy and we had a great conversation. He's a Royal Air Force veteran himself, so he and my dad traded stories and had a fine time.
After a few minutes of talking, Martin asked if we wanted to leave a little early. With no set plans, my dad and I were happy either way - after a quick discussion, we decided to leave early. Martin asked about ground transportation, and I told him we were good to go.
We headed
Martin asked us if we wanted a picture together before we got on the plane. We grabbed the quick picture, which looked something like this:
 |
| Cockpit picture courtesy of Embraer. All rights reserved. |
 |
| Cabin picture courtesy of JetSuite. All rights reserved. |
Pretty nice, huh?
Carey sat in the cockpit and started the pre-flight checklist while Martin gave us the typical pre-flight safety briefing. Seatbelts, exits, floatation devices, liquor cabinet.
Wait, what? Liquor cabinet?
Since it was early in morning - and I didn't really feel right eating and drinking a bunch on a free flight - I opted for water and my dad had a Diet Coke. Martin told us to feel free to help ourselves to any of the beer, wine, booze, soft drinks, water, or snacks we'd like. He told us about the XM satellite radio and the Bose noise cancelling headphones. He asked about ground transportation at our destination again, and I missed the hint and said we were all set up.
He joined Carey on the flight deck and my dad and I settled into our cushy leather seats, grabbed our beverages and prepared for takeoff. Which, in this case did not involve shutting off cell phones, wishing for that crying baby to settle down or trying not breathe in other passengers various body odors. We quickly taxied to the runway and were on our way. One of the 9,426,874 benefits of flying charter from a smaller airport, I learned, is that you don't have to wait long - or sometimes even at all - for the tower to grant you takeoff clearance.
As we accelerated down the runway, I'm sure I was grinning like a complete fool, but we rotated smoothly and climbed out quickly. During the 6 or 7 minutes it took us to get to our cruising altitude, we played with the Bose headsets and listened to the Police sing about stalking somebody. We didn't take this trip to listen to the radio, though, so we put headphones away and stretched out. I'm over 6' tall but I had plenty of leg room and headroom. The overall cabin height is a hair under 5', but once you get seated there's plenty of room.
The ride was amazingly smooth. We spent a couple minutes looking out the windows and enjoying the flight. Conversation was surprisingly easy, and while the engines were loud enough to notice we were able to talk without any difficulty at all. Martin looked back to check on us a couple times, and we were able to talk to him easily, too.
For a small aircraft, I was amazed at how well insulated and quiet it was. One of the inherent issues with the very light jets is engine noise - with the jet engines and cabin being so close together, there is bound to be some engine noise, but the Phenom kept it to a minimum.
At our fastest we got up to around 375 mph (325 knots), so we made it to our destination pretty quickly. We started our descent much sooner than I would've liked, and caught one brief and surprisingly gentle bit of turbulence on the way down. We fell into the traffic pattern and lined up for our final approach a couple minutes out. Martin and Carey brought her down so gently we couldn't even tell when our flight officially ended.
After a quick roll down the active runway, we made our way via a couple taxiways to our final destination. Martin and Carey brought the plane to a stop and we gathered our things. We stepped off the plane and back into the real world. A short 50 foot walk later and we were at the door to the FBO.
We walked through the door and were immediately greeted by the aroma of fresh baked chocolate chip cookies and still-popping popcorn. As we grabbed a cookie, Martin thanked us for choosing JetSuite, and we thanked both him and Carey for safe a safe, comfortable and pleasant flight. When he found out that my grand plan for ground transportation was to hail a taxi, he excused himself to speak to the FBO's concierge. He returned moments later to let us know that our car would be there in fifteen minutes. He told me to let him know my ground transportation plans and needs next time and they'd have the car waiting for us on the tarmac. Talk about door to door service.
My dad grabbed an iced tea while I took a seat on a couch in front of a huge and yet somehow still tasteful big screen TV to catch up on the news of the day. We were there for less than ten minutes when we were told that our car was there. We stepped outside but found no cab. Confused, I turned back toward the FBO. That's when I saw the Lincoln Towncar with the driver holding the door open. We jumped in the car and the driver slid behind the wheel. He already knew our destination - the concierge must've told him - and he guided the car smoothly into traffic and headed for the train station.
I'm not gonna lie - this car was just a little bit nicer than the beat-up-Crown-Vic-retired-police-car-hunk-of-junk cab I was expecting. You know, like the Packers are just a little bit better than your average team of winless high school freshmen. Luxurious leather seats, no meter ticking annoyingly away, and no unidentifiable stains on the seats or floor.
I knew of JetSuite's partnership with Dav El for ground transportation, but I knew nothing about the price. I was fine with spending $50 on a cab, but I was a little hesitant about spending a ton of money on executive ground transportation. Less than ten minutes later we pulled up to the Amtrak station. The driver got out and opened the door for us, and informed me that the ride was $30.
Thirty American dollars?!? That was significantly less expensive than a cab would have been for a much nicer ride. Even with the tip I came out ahead on that deal. We walked into the train station, picked up our tickets and found a bite to eat while we waited for the train.
The train showed up and we boarded. No TSA screening, but it wasn't quite the same as walking up the airstairs on to the jet. It was a slow day for Amtrak and we essentially had the entire train car to ourselves. That was nice, but it's definitely not the same as having your own private jet. Sigh. The train ride was relatively uneventful... until we rode back past the airport.
That's when we saw that beautiful Phenom sparkling brilliantly in the early afternoon sun. I gazed longingly at the Embraer as the train rounded a bend. I'd have to be big boy. I had to maintain my dignity. There's no use crying over spilled milk, there's no crying in baseball, and there's certainly no crying in train cars - no matter how great the plane you're looking at is.
I had plenty of time to think over the day while we were on the train. We spent about 45 minutes in the plane, and the better (worse?) part of 7 hours in the train.
In the end, I figure it broke down like this:
Anticipated cost
SuiteDeal: $536.43 ($499 + 7.5% excise tax)
Breakfast: ~$25
Lunch: ~$30
Dinner: ~$50
Cab ride: ~$50
Train tickets: ~$80
TOTAL: $771.43
Actual cost:
SuiteDeal: FREE
Breakfast: $9.40
Lunch: $15.09
Dinner: $13.66
Ground transport: $40
Train tickets: $72 (Senior discount for my dad made it 10% cheaper for his ticket)
TOTAL: $150.15
In the interest of presenting a valid review of my experience, and in the sake of full disclosure, I figured I should share the negative parts of the experience, too. I thought long and hard, and have been able to come up with exactly three things that weren't amazing about the experience. In no particular order, here they are:
1) I had to bend over to board the aircraft (but too be fair that's a stretch - all very light jets have short overall cabin heights, and the Phenom's height was very respectable)
2) The engines were noisier than I would have liked (again, an issue with all very light jets, and a very small issue)
3) The XM radio is controlled from the cockpit, so the flight crew has to change the channels for you
Again, these are all such trivial issues that I really had to get nitpicky and think long and hard to find ANY negatives. I think issues 1 & 2 are easily offset by the lavatory that's standard on the Phenom 100 - many VLJ's aren't equipped with any restroom facilities. And number 3 is laughably insignificant.
The only legitimate downside to the whole experience is that I am absolutely, completely and undeniably ruined for commercial aviation. The JetSuite experience was far beyond my expectations, and I cannot say enough good things about the company, the staff, the aircraft and the entire experience.
If you ever have the opportunity to fly with JetSuite, I'd jump on it. You can learn more about the SuiteShares, SuiteSavers, and SuiteDeals on their website and Facebook pages and their marketing department is always coming up with new ways to get you into one of their aircraft. Their Black Friday promotion was simple: $1 - yes, one dollar! - for all their SuiteDeals for the entire last week of November, and they recently flew some lucky folks from Teterboro, NJ all the way to Los Angeles for $800. You'd be hard pressed to find a single one way coach ticket from NY to LA for the next day for that price, let alone 4 first class seats.
I'd also like to acknowledge the great service from the fine folks at Signature Flight Support and Atlantic Aviation, the two FBOs that served us on our trip.
I think the whole experience can be summed up best with three words:
JetSuite: It's JustSuperb
Subscribe to:
Posts (Atom)