When an ambulance is dispatched to a medical emergency, there may be many obstacles incurred during the response and patient treatment. Sometimes these obstacles require additional help or resources to help the medical crew. Ambulances are equipped for providing medical care and do not carry the necessary equipment to effectively mitigate every incident they are dispatched to. Cases of entangled patients, access issues, environmental concerns, and even locked doors may require additional assistance on the scene.
When ambulance personnel responds to locked buildings, they have several options to choose from. They can call for the police department or fire department to force open a door. They can have a key holder sent to the address to let them in. They can also have their dispatch contact the property owner to open doors or get lock codes. And sometimes they need to find their way into the building.
How an ambulance crew decides to face a locked door varies from location to location. Some take into account state and local laws on what can and can’t be done to a locked building in this circumstance. Another issue is just how strong or secures the doors are. Will they need to be cut or removed to gain access? If so, the fire department may need to be involved.
The patient’s condition also has a role in deciding how and when an ambulance crew gains access to the property. For example, if the patient seems to be stable and can verbally interact with the medical crew, the crew may wait for a key holder to get there and unlock the door. If, however, the patient cannot be communicated with, or looking in a window reveals an immediate need to get into the property, more emergent needs may be attempted, such as kicking down a door or breaking a window to enter.
The three main determining factors in “forcing entry”-the technical term-are the patient condition, the safety of the medical crew, and the level of difficulty or skill necessary to enter the building. When considered together, these three factors form the foundation in the decision to enter a locked building.
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Safety of All Involved
As with most situations in emergency first response, safety is the most important factor for responders. Dangerous or unstable scenes will not be approached until the dangers are mitigated. Even something as simple as a locked door can become a pretty involved process.
Locked doors indicate the fact that the resident can not get to the door. For some reason, they are incapacitated. It could be from a variety of circumstances, such as environmental conditions, such as noxious chemicals or odors that have caused the condition, or the result of mental problems where patients have barricaded themselves inside.
Because of these safety risks, different assets may be requested by the emergency medical responders on the ambulance to enter a building. Seldom will policies allow them to break a building, although it happened with immediate threats to life.
There could also be other hazards in the building, such as aggressive dogs or other animals that might either attack the rescuers or end up escaping in the commotion. Another hazard may be individuals hiding in the building. If the patient has been assaulted, the perpetrator may still be in the building causing a dangerous situation for unprotected responders.
Even something as simple as breaking a window or kicking in a door to get into a building can result in injuries to the emergency medical responders who do not carry the equipment or personnel protective equipment to do it safely. For this reason, most emergency medical agencies have policies where breaking into locked buildings is left to the police or fire departments.
Patient Care as a Factor
Second, to the ambulance crew’s safety concerns, the primary driver in the method and speed at which a locked building is entered is the condition of the patient. If the patient is stable the ambulance crew may simply wait for a family member or neighbor to arrive with a key.
An example of this would be an older patient who fell but is not complaining of major injuries. Often in cases such as this, the crew can communicate with the patient and confirm the patients’ medical condition. If there are no expected major injuries, the crew can simply wait a few extra minutes and gain access to the building without risking injury or causing damage.
In situations where the patient’s injuries or condition is more emergent, the ambulance crew can have their dispatch contact the police or fire departments for assistance. Many times, these agencies are dispatched with the ambulance crew when there may be a need for forced entry into a building.
The more serious the possibility of injury or medical condition, the more haste and lack of care is taken in gaining entry. If the patient is experiencing life-threatening conditions, such as major bleeding, taking the time to wait for other agencies, or taking care to gently enter a building will be put on the side burner and the fastest way possible will be utilized
Property Damage Needs to be Considered
Another consideration emergency medical crews need to take into consideration when contemplating the need to break into a building is the amount of property damage that might be caused. At times, the damage may result in a situation where the building can not be secured when they leave. For example, if the ambulance crew kicks down a door to gain access to a patient, when they leave, the door may be damaged to a point where it can not be locked again, leaving the building vulnerable to thieves or trespassers.
Property damage also adds up quickly. A broken window could cost hundreds, even a few thousand dollars to replace, and door replacements can come close to that as well. There is a liability that comes from damaging property in terms of who is going to cover the damage.
Police and fire departments have techniques and tools available to them that cause very minimal damage. These resources are typically not available for emergency medical crews on the ambulance, and this reinforces the generally accepted policies of why emergency medical crews do not force entry into buildings.
Agency Rules and Relevant Laws
Emergency Medical Services have policies and guidelines in place for ambulance personnel. This is designed to not only protect the ambulance crew, but also the company or department from lawsuits and other liabilities. Having emergency medical personnel break-in into unfamiliar buildings with limited resources can be extremely dangerous, and most agencies will avoid it at all costs.
There are also other legal factors to consider for the ambulance crews as well. Some jurisdictions require law enforcement to be present whenever entry must be forced into a building. While this may result in delays on the rare occasion, the overall safety for all involved outweighs the possibility of delays in inpatient care.
Many times, when ambulances are dispatched to check on people not seen for a few days-called welfare checks-law enforcement units are dispatched with them. In many of these cases, the resident simply is not home or left for a few days. Law enforcement can track down family and contacts in ways the ambulance crew cannot, making the presence of law enforcement a vital tool in situations where the emergency medical crews are locked out of buildings.
When ambulance crews are faced with situations where locked doors prevent their access to potential patients, there is never seemingly an easy solution. Multiple factors must be weighed in making the decision to break into a building. Every situation is different, and crews must rely on experience to make the best decisions for their own safety and the treatment of their potential patient.
How hard is it to actually break into a building?
When we hear about needing to break into a building or residence, the picture we drum up can vary greatly depending on where we live. In rural America, the thought of breaking into a house seems pretty easy. Kick in a door and you are in. Just like in the movies. Breaking into a single-story home can be pretty easy at times, but it is not without its challenges.
New construction is a lot more solid than it used to be. Door and window casements are a lot sturdier and, if specifically manufactured to keep people from breaking in, can be a challenge. Reinforced areas, interior braces and stops, and multiple locks can all be found in neighborhood homes nowadays.
For those living in big cities, the need for the fire department to open doors is more obvious. Multistory apartments and town houses do not allow access from outside except for the ground floor. The doors into the residential areas are usually metal doors that have metal casements and multiple locking mechanisms.
While tracking down the landlord or superintendent can provide keys to keyed locks, many doors still have chains or other locking mechanisms that can only be locked or opened form the inside of the door. These doors will usually end up bent or deformed, and sometimes actually require holes to be cut in them to gain access to the interior locks and stops.
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Please note: This blog post is for educational purposes only and does not constitute legal advice. Please consult a legal expert to address your specific needs.
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