Increasing awareness

Guys ,

How do I minimize being blind-sided ??

Twice this week , I have been blind-sided . Both times I was on the job (paramedic) , and was attending to a patient when suddenly the intoxicated spouse moves in quickly ... in both cases there was not a threat ; they just needed to get close to their man before/as we carried them off . But after each of these calls , I'd get a dissapointed feeling wash over me because it was apparent that if the spouse (or anyone in that bar etc) 'had' been a threat , then I would definately have been caught off guard ! I think it may have in one of Geoff Thompsons books , that I recall him mentioning a few guys dying at the hands of an irrate spouse or mother ; different circumstances , but the message is clear .

What sort of exercises/practices can I employ at work so that I eventually learn to minimize these potential threats ? How do I stay so focused and aware on a call , that I can treat my patient thoroughly , yet still stay aware of the surroundings .. the people , the space etc .

I usually pan around or walk the walls when I enter a call , as well as a few times during treatment , but somewhere along the way I'm currently allowing for the possibility of an ambush . I'm not doing enough ...



In an effort to evoke a realization I shall be blunt,
for the purpose of succinctness...

While your quest is noble your fixation will create

You need to trust the inuitiveness of the survival
system....remember, thats what the SPEAR
SYstem is predicated on.

Theories are great on paper and tactics are great
when there is consent and both participants are
actively exploring a drill, but you cannot create
awareness when you are intensely focused on
something else.

As a patient, I want you frickin focused on your job
not looking for a fight.

Your job is to save & heal, if the fight comes to you
you defend, if its telegraphed you intercept if
possible, but you need a are a
paramedic not a Bodyguard...big difference and
thats the problem with all these books and
systems, they contain good information but never
from the perspective of ambushee always from the
POV of sniper, so any bouncer awareness drills or
cop awareness drills or martial awareness drills -
while they are possibly excellent "fighting" skills -
they will not not transfer to paramedic self-
defense...a sucker shot is a sucker shot and thats
why they call it that...does that make sense?


*If you dont quite grasp this, much of this info will
soon appear elsewhere, slightly modified, names
changed to protect the origin. Inside joke. NTK :-)

"While your quest is noble your fixation will create paranoia..."

Agreed ! Though the review of these incidences left a sour taste in my mouth , my brain kinda stalled out when I realized the answer was almost to see everyone in the room all the time *L* . I thought to myself , Christ , how the h3ll can I do that ?? I'd look and feel like some strung-out nut ! ;-)

Your reasoning puts me back at ease , and gives me back permission to focus as solely as I was .. on my patients .

Thanks for the re-frame Tony .


If I can offer a suggestion.

Do you have the man power for a 1 person/1 job approach?

Can you ask the local PD for standby service?

If the answer is yes to either of those questions, you can focus on your job, which you must, with someone else maintaining control of your/the environment.

Paul...of course often the Paramedic
is there first or an LE is securing a scene or
interviewing someone...but Paul raises and
important 'proactive' point: intuitive intellegence...

i.e. if you arrive at a scene where there's been a
shoot out, a drug deal gone bad, domestic
violence, part of your verbal commands at the
scene can be 'security' concerns and also
recognize that the person youre working may be
your oppoent too when they 'suddenly' regain
awreness or consciousness...remember
improved perception speed improves reaction

Another point I ommited from my first post is that
your surival system generally WILL NOT pick up
'Not Danger' and should pick up 'danger' your
examples, you were ALMOST blindsided by NOT
danger (makes no sense) get it? Had you said "I
was struck by the spouse..." my answer likley
would have been the same as above, focus on
your job, youre not security...but to beat your self up
because you didnt notice NOT danger is pushing

Another subtle reframe.

Some would call it common sense, but as you
know from reading our research, we lovingly refer
to it as 'uncommmon sense'.

Food for thought.


*Uncommon sense (a unique play on words
coined through TCMS research to define what
isnt obvious but should be and can be....also a
unique play on words based on words that people
play with. NTK CORE HUMOR)

I understand what you're driving at Tony .."but to beat your self up because you didnt notice NOT danger is pushing it." I guess I was playing what if , and trying to lite a fire under my butt to arrive at what I could be doing differently in some instances .

Incidentally , in one of the calls , I did recognize the wife as a potential problem , and immediately asked the 10-200's to remove her from the area ; which they did nicely . Problem is I didn't articulate 'securing' her until we were gone , and of course , just as we arose to leave up she came at us from across the room .

The other call , the wife had taken a swing at me ... I told her firmly to sit down on the couch .. which she did . But after , she appeared 'right' behind me as we when out the door ... like I said not a huge threat at all , but gave me pause to think .

Good food for thought Tony ,

Thanks ,



"of course often the Paramedic is there first or an LE is securing a scene or interviewing someone..."

Actually, I was thinking more along the lines of Cover/Contact. If Varley's agency has the manpower it would be worthwhile for them/him to have some dialogue on this issue. With a 2-3 man ambulance crew Cover/Contact could be done in a way to keep them all safe and not present an antagonistic presence to the "spouse" or whomever. With a litte planning and rehearsal during the next training opportunity they can work this out.

Likewise, if they don't have the manpower, running short has always been the trademark of emergency services, they could request standby service from the local PD if they aren't already there. With a little communication between the EMT/Paramedics and the Officers cover issues can be addressed and the paramedics can than get on with doing their job without distraction.

"communication between the EMT/Paramedics and the Officers"

Paul , our city paramedics has a great relationship with local officers , who always seem willing to help in any way they can . We (medics) work exclusively in 2 man crews , and with the array of advanced skills we now employ we are very often both busy with IV's drugs , monitors etc . Now that I am in tune with my intuition , what is left as Tony indicated , is intuitive intelligence . If my radar goes off , I need to swiftly engage the LEO's nearby to assist (being specific as possible) , or if we are alone on the call , I need to articulate to my partner what I'm sensing .. include him in that evaluation , and make some quick choices to deal with it .

So from what you and Tony have said I gather the flow to be : (1) Intuition , (2) Intuitive Intelligence , (3) Evaluating Choices , (4) Communication , (5) Action , (6) Relying on my training to defend myself if an ambush ever happens .

If I've missed a critical step or any nuance , can you let me know ?

Thanks , Var