“I hate you, papa.”

Those were the last words of a dying child, beaten for hours by her mother’s boyfriend. The man beat the child for most of a day; when EMS and law enforcement were finally summoned, the limp child was found in her bed. Hospital staff worked to revive the child; however, she succumbed to her severe injuries. A law enforcement officer in the ER noted the girls last, powerful words in his incident report. Another article told the story of a child beaten to death by both her mother and father. When brought to the hospital, the child was covered in bruises, old and new. X-rays showed current and old broken bones. Neighbors said the child was constantly screaming in that house. The grandparents said they were concerned for the child’s safety. No one, neither family nor neighbor, intervened for these children.

As firefighters, many of us wear our leather helmets with pride and see the fire service as protectors of all people. Without a search warrant, we have unique opportunities to see what other agency representatives rarely get to see: the inside of a home, bared to us without much attempt to whitewash living conditions. Firefighters are in houses for medical calls, public service calls, and fires. We are able to see how people are in their day-to-day lives.

On your next medical call, when examining and caring for a child, will you look a little harder at what you see? Will you assess the child and try to determine his/her wellbeing?

1. Is the child overly dirty and uncared for?
2. Condition of diapers? Changed, as needed?
3. Child look in good physical condition and well fed?
4. Appear to have an exceptional number of bruises and/or other injuries?
5. For age, appear to appropriately respond to stimuli?
6. Living conditions: acceptable or unsafe squalor?

Today, at the kitchen table, discuss this article. Ask if any member has run across anything similar in his/her past work. How was the problem handled? Does your organization have a method to report child and/or elder abuse? If there is not a policy or other method, does your organization need one? What do you think should be in the policy? Until the policy is developed, how will you and your crew handle a call similar to those in the above paragraph?

Children don’t have the necessary skills to communicate in the adult world. It’s up to us, as adults and as firefighters, to speak for those without a voice. Will you have the courage to protect a child and report a situation to social services?

Silence is acceptance; inaction is approval.


  • RickyBobby says:

    When I was active in both EMS and Fire, and working for a private ambulance company, I saw many conditions that I wanted to report to someone. Sadly, sometimes even in the facilities where I was transporting patients to and from. When I was new, I’d talk it over with coworkers. As I grew more confident in my field, I learned to correct the problem myself, which to me fell under basic patient care, common sense, and common decency. If I couldn’t correct the condition myself, and never beyond my scope or level of training, I made sure someone corrected the condition before I left my patient.

    When it came to the town I protected, things were a but different. We were minutes away from the hospital and we had PD response on every call. If conditions were unsatisfactory, they were noted, and generally followed up immediately.

    I realize that I dealt with mostly elderly patients, but the conditions are similar. Does the age of the patient affect our reaction? Regardless of the age of the patient, I would hope, as responders, that we would not remain silent.

    Do you think this should be part of your SOP’s? Is there a hard and fast rule, or is it a judgement call? Are we afraid to say something for fear of legal repercussion?


  • emaguy says:

    RickyBobby, you make some excellent points in your comment. I’m very happy to see your bridging the child abuse/neglect problem with elder abuse/neglect. As the US population ages, I believe emergency services providers will note an increase in cases of elder abuse.

    Additionally, in the case of nursing and/or personal care homes, you are right to attempt correction of identified problems. Discussing the issue with the nursing assistant, charge nurse, nurse manager, or facility director can be a great way to make an immediate impact on conditions. I applaud you for your attention to the patient and efforts to improve his/her care and living conditions!

    You questioned if this should be part of an SOP, etc. I’m not sure an SOP is the most effective manner to approach the problem. I think a guidance document, SOG, may be a better approach. Procedures are meant to be followed to the letter; guides provide information about several options which my be used to effect needed change.

    Although my thread was about abuse, neglect or inability to care for a child or elder can be just as devestating. Many years ago, I worked for a VERY rural emergency services agency. During a call, my partner and I noticed the children were crying and asking the mother about food. I asked if things were okay and she told me the situation was not okay. The family didn’t have a car, had no money, and the parents were not working, though looking for work. There wasn’t any food in the house and there was no way for the parents to get to food.

    When we returned to the station, I went to the church next door and talked with the preacher about the problem. Immediately, church members made food deliveries. Also, the church helped the family get in touch with social services for longer term food and other assistance.

    You are right, someone must speak up. Silence helps no family in distress.

    • RickyBobby says:


      What a great idea and response to the immediate problem. Not only were you to notice the children in need, you provided a solution on multiple levels. Too often we get caught up in our daily lives, our own financial situations, issues at home, or what have you, to notice the plight of others. Plus your solution gave the congregation an opportunity to reach out to someone in need and see an immediate result.

      Unfortunately, people in general tend to see people in this situation and think it’s not their problem, it’s not their concern, or worse, the parents are lazy, or just looking for handouts. Whatever the case may be. And then around Thanksgiving or Christmas they’ll donate a can of corn and feel good about themselves.

      But then, this is nothing new. We (firefighters/EMS) have seen both sides more than we can count. And, as you stated earlier, we have the ability to see what others cannot legally see. Even if the preacher never gave your name, or even mentioned your department, that family will remember your actions forever.

      So that leads me to ask, are we in the field naturally compassionate because we’ve chosen this as our career, is it natural or human instinct that drives our reactions, or is it learned process through training, testing, and observation? Or a little bit of all of the above?

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