EMT/Police/ER response

Well, first the cops need to secure the scene, i.e. make sure there's no active shooter around before EMS goes in. What L has sounds like a soft tissue injury, probably a laceration if it was a grazing shot or penetrating/perforating trauma to the arm. If you want it to be manageable there shouldn't be any major vascular damage or trauma to the bone. Since this is a non-life-threatening injury the EMTs should do a physical assessment with vitals, take L's history (what exactly happened, does she have any underlying conditions, other health problems and so on) and dress the wound. If it's hemorrhaging badly and/or they suspect a bone was involved they'll also splint it.

Whether or not L's friends can come along depends on the EMTs. I'd tend towards no, I don't do it unless I have to and most other EMTs I know also don't really care much for passengers who aren't any help, like a parent for a pediatric patient. If one of them does get to come along, he'll probably be in the cab up front.

Hello.

Well, I can speak to some of the ER stuff...

I'm typing this as my husband dictates. (He's not an er doc, but he is a doctor.)

Unless the injury is obviously very superficial, the concern would be for a vascular injury. If there is any clinical sign of an abnormal pulse or a large hematoma, they might do some imaging studies, such as a CT angiogram. Also, they will at least get an x-ray to see if there is any associated fracture or bullet fragment that might need removal.

If all of those studies are normal, or there is no reason to suspect any bony or vascular injury, they shouldn't need to be there more than an hour or so.

Depending on how big the wound is, they may get antibiotics (amoxicillin maybe) and pain pills.

Hope this helps

The odds of police responding to a bystander hearing something that sounds like a gunshot is pretty low, like single digit low. Also, an ambulance won't be dispatched in this case either. The first thing that might happen is that a police cruiser -- with one officer, not two btw -- might be dispatched. Odds are, unless there is a specific address the officer will just do a drive by and keep rolling if he doesn't see anything.

If the officer finds the people, or they flag them down, then he will ask them what is going on, call for backup, and after that an ambulance will be called to the scene and reporting to a hospital will be mandatory.

But yeah, as a former cops and court reporter I have an easier time believing in magic than I do that an officer would be dispatched in a timely manor to reports of a gunshot.

I'll second most of what MDSchafer said: I don't see the cops arriving that quickly. If there was a non-involved visual witness who called the 911, maybe. But the odds of either cops or paramedics showing up immediately without 911 being called/just due to a report of gunshots being heard seems really slim.

As far as the passenger in the ambulance, eh, that also varies. The only time I've seen it likely a non-injured person gets to ride along in the ambulance is when the injured person is a minor. The extra passenger is always a parent or guardian, and I've never seen both parents/guardians be allowed*. Most of the time people have to find their own ride, though here it's not unheard of for a cop to bring one to the ER.

(*I see many a' ambulance as I work in an emergency department.)

MDSchafer said:

The odds of police responding to a bystander hearing something that sounds like a gunshot is pretty low, like single digit low. Also, an ambulance won't be dispatched in this case either. The first thing that might happen is that a police cruiser -- with one officer, not two btw -- might be dispatched. Odds are, unless there is a specific address the officer will just do a drive by and keep rolling if he doesn't see anything.

Click to expand...

It's NYC, per OP's post.

ladyleeona said:

As far as the passenger in the ambulance, eh, that also varies. The only time I've seen it likely a non-injured person gets to ride along in the ambulance is when the injured person is a minor. The extra passenger is always a parent or guardian, and I've never seen both parents/guardians be allowed*. Most of the time people have to find their own ride, though here it's not unheard of for a cop to bring one to the ER.

(*I see many a' ambulance as I work in an emergency department.)

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Yep, that's about the only scenario IRL where we take passengers. There's only so much room in an ambulance and we do have to work in there. The most common scenario for people who really want to come is for them to follow us. (I hate those scenes on TV when someone just randomly jumps into the ambulance declaring "I'm coming with you to the hospital." Yeah, no, get the hell out of my truck.)

MDSchafer said:

But yeah, as a former cops and court reporter I have an easier time believing in magic than I do that an officer would be dispatched in a timely manor to reports of a gunshot.

Click to expand...

It happens all the time here (with two officers being dispatched). We got Shotspotter, though. I don't know if NYC has that.

I can't give you any cite for it, but I'm pretty sure NYPD officers don't ride solo. They may patrol alone on foot, but there's always two per RMP (unless it's traffic enforcement or something.)

I'm obviously a student paramedic here, so I'm not sure how much applies to NYC, but from what I've observed, it largely depends on the availability of transport on whether someone other than the pt gets in the back. We have room for the pt, plus three passengers, so if we're in the middle of nowhere, sometimes we'll give a lift in to the partner of the pt if they don't have transport. Sometimes, if the other person is a potential pt (ie, they were in the same car crash, but don't appear to have any injuries), we'll take them in the ambulance because we don't really want them driving in. Also if the pt is not easy to calm, and their significant other/case worker/friend has a calming influence, we might take them with us.

Basically, if you're not a nuisance and make life easier, sure. If the pt is on the edge of dying or very very sick, no, because the other person will just get in the way. Everyone has their assigned roles in this sort of scenario - adding an extra can confuse things.


So it really depends. The only exception is kids. I'm not sure of the legal situation in NYC, but here, you can't take a kid in without their parent. The hospital needs that parent for consent to treatment, stuff like that. We also need the parent to consent to treatment. The only exception is if the minor is dying, and then you do what you have to do to keep them alive, get them to hospital, and let them sort it out. Normally what happens is the pt is kept alive until the courts can argue over whether or not the parent has the right to refuse treatment.

As for times in the ER - she'd definitely go to hospital, because there's no way of knowing how much damage the bullet has done without an actual medical opinion. Given the emotional shock, the adrenaline could also be hiding other injuries/masking other pain signals. I wouldn't be leaving her there. Once at the ER, if her wounds are not causing physiological effects, I expect she'd have to wait a while. Again, systems are different here, but as paramedics we have duty of care until we hand-over and put our pt on a bed, so she'd be stuck waiting on the stretcher until a bed was made available. She'll probably need admission if there's a penetrative soft tissue injury involved, because they'll want to check for scarring, nerve damage, hidden bleeding, that sort of thing.

I've waited up to 4 hours to offload a non-critical pt. She could be stuck there for a while. The paramedics will probably ask her friends to follow in a taxi. The cops will want to talk to the pt before she leaves, and they'll probably take statements from her friends before they allow them to go. All three will be checked out to make sure there's not hidden injuries ect.

I hope that helps. Again, I'm not sure if this is exactly how it would work in NYC, because there are obviously different qualifications, laws and protocols involved, but I can't imagine it being too overly different.