Self-Defense and Medical Preparedness – Part 1

The following post on medical preparedness is contributed by Pete Farmer,  who holds advanced degrees in research biology and history, and is also an RN and EMT. 

I’d be very interested in comments from those of you who have served in areas of civil unrest or societal collapse (see comment form below). – Doc Cindy

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Medical preparedness is only one aspect of overall preparedness. This basic truism is often forgotten amidst the challenges associated with getting your medical skills, supplies, training and experience in order. However, being a well-qualified and well-equipped medic (professional or otherwise) isn’t enough. You must concern yourself with other aspects of preparedness in order to cover all your bases. One of these is the necessity of protecting yourself, your loved ones and local community.

Consider the following… 

In the immediate aftermath of natural disasters, such as Hurricane Katrina, civil order often breaks down, partly or totally. The thin veneer of civilization falls away. Especially in the first hours and days after the disaster, when local law-enforcement and first-response resources are likely to be over-extended and swamped,  looting and other forms of violence and property crime are likely to increase dramatically. Until the military and other state/national assets arrive on the scene, you and yours may be on your own. That means self-defense will be your responsibility. 

Some readers will recall the 1992 riots in South Central Los Angeles, following the verdict in the Rodney King case. Witnesses said that conditions approximated those of a war zone – police battling rioters, numerous fires burning, cars overturned and set ablaze, people running wild in the streets, random acts of violence and lots of looting. Among the few businesses in the South Central Area to survive the riots relatively intact were those in the Korean-owned commercial district, whose owners and employees armed themselves and stood watches to repel looters, by force if necessary. 

According to an MSNBC story by Chris Hawley (6/25/11), An Epidemic”: Pharmacy robberies sweeping US, pharmacies are increasingly targeted by drug addicts, dealers, and flash mobs. In one such incident, a botched robbery of painkillers at a Long Island pharmacy turned into a multiple homicide, with four deaths at the hands of the gunman. In California in 2010 there were 61 robberies of pharmacies. Other states report similar increases in such crimes. The targeted medications are almost always hydrocodone-based painkillers such as Vicodin and Norco, or oxycodone-based medications such OxyContin or Roxicodone, which are highly addictive. 

As the above examples demonstrate, medical personnel, whether professional or avocational, need to have plans for security contingencies in place. That means acquiring self-defense skills for yourself and your colleagues, arranging outside security protection of some kind, or perhaps both. Unfortunately, the criminal element may not be the only problem, either – if medications and other needed supplies run short in the aftermath of a disaster or unforeseen “Black Swan” type of event, the medic may be forced to cope with refugees, crowds of people seeking help, and similar scenarios – in addition to his/her normal duties and functions as a healthcare provider. 

Security and self-defense, then, involve some of the following considerations and parameters: 

  1. Personal self-defense – protecting yourself against immediate threats to your safety and well-being, as well as those in the immediate area.  
  2. Defense of your aid station, clinic, supply depot, pharmacy, hospital, surgical theater, or other facilities, equipment, and supplies.  
  3. If you are in the field, protection means securing your surroundings, just as a medic or corpsman on patrol with an infantry unit would do.  
  4. Physical security – locks, alarms, and other physical barriers to prevent theft or unauthorized access to drugs, supplies, and other materials.  
  5. Shelter, cover, and concealment – Your clinic, aid station, etc. should be sited in such a way as to provide as much physical security and protection from the surrounding environment and threats as possible, while still remaining functional and assessable to caregivers and patients. Cover provides physical protection behind which an individual or a structure can shelter; concealment is anything that hides or makes less-visible those same things.  
  6. Procedures and protocols for handling the flow of people in and out of your aid station or clinic. In particular, handling overflow of patients, refugees, and other crowds. Medical and security SOPs should be developed for triage and treatment of mass casualties.  
  7. Sentries and overwatch protection – these are the people who provide the physical security surrounding your operation, and defend it against attacks and unwanted intrusions. Typically, these are non-medical personnel, although it should be stressed that medical personnel comprise the inner-most defense of the area, should the outer ring of protection prove insufficient. That means all medical personnel should be trained and proficient in the basic handling and use of small arms. Typically, medical personnel are non-combatants, and do not use lethal force unless they or their patients are directly threatened.  

In the next installment on medical preparedness and self-defense, we delve into some of the specifics of this important subject, such as firearms training, hand-to-hand self-defense systems, physical security, how to set up a secure aid station or clinic, and much more. We will also look at some resources available for helping you get up to speed on these topics.  

Copyright © 2011, Peter Farmer

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About Cynthia J. Koelker, MD

CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
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