Stranger Danger: How to be Safe in the Urban Environment

In today's chapter, we'll be covering the number one threat to your life and well-being (besides yourself): other people. Now, don't get me wrong, you're not at all more likely to be a victim of violence than an accident of some sort- it's quite the opposite, in fact. However, were it not for other people driving, we'd lose a significant number of motor vehicle accidents (though most accidents are actually single-vehicle, some driver going down a rural road way above the speed limit trying to make a turn twice as fast as they should have); were it not for others, it's unlikely we'd ever catch the flu and a grudge for that person that didn't understand the concept of sneezing into a tissue or shoulder; were it not for other people, we'd rarely have anything even close to the violence against others that it seems we hear about every day. Back on track, though, we'll be more discussing the potential for interpersonal violence, how to recognize it, how to prevent it (the most effective way of dealing with crime), how to react should all else fail, and how to work with law enforcement officials and other responders after the fact. At the end, we'll review specific crimes, how to recognize the potential for them, how to prevent them, how to respond, and how to work with emergency officials.

What is interpersonal violence? I ask this because we sometimes take things at face value or for granted when there's actually a lot more to the issue to be examined. Interpersonal violence doesn't always have to be confined to physical harm- just the very threat of it, the impact an act or deed has on someone's day-to-day life, can be considered to be a violation inflicted on one's life by another. Take, for example, a breif bit of fiction in which a young woman in an average suburban neighborhood walks past a few low-lifes hanging out on the other side of the street. Now because these couple of guys are up to no good, they start making trouble in the neighborhood- starting by, in this instance, shouting to her that they're going to steal her phone. Even if they never actually make the effort to take her phone, the act of threatening her will probably make her change her routine in the future for the sake of avoiding future trouble because she feels her safety, as well as her phone's, has been violated and does not wish to recieve further violations. More saddening, though, is the reality that people do worse things than threaten with words- they sometimes actually abuse, lash out at, and attack other people's minds with words (verbal abuse).

Violence can be even more abstract than words- as an example, theft. What if someone held you up for your wallet, broke into your house while you were out, or stole your identity? You've just had a horrible thing done to you, and most of the time these days (as in two out of three of the preceeding examples), you never even see your assailant face-to-face. Think about what changes your life would undergo following such a horrible event, how insecure you would feel. Theft is almost a form of mental abuse, when you think about it. The point that I'm driving at is that in looking out for and recognizing interpersonal violence, don't limit your scope to just that which leaves blood, bruises, and broken bones.

Where can violence occur? Unfortunately, the fact of the matter is that violence can be a reality for anyone, anywhere, at any time. However, if you know the patterns, you can lessen your chances of being a victim of violence.
-In any area where you're clearly foreign, be it another country, or just another region or ethnic center, your risk is much higher than in your home territory. The reasons abound, but the most important ones are that you're recognized to not be someone who's going to have connections in that area, you're recognized as probably not knowing the area very well, and you're less likely to be sympathized with.

-Any area that's particularly less-traveled, secluded, or abandoned presents an increased risk. Primarily, this is because people don't like criminals in general, and criminals doing their deeds in public means airing their dirty laundry to everyone and their grandma- and, if grandma's feisty enough, getting their laundry washed as well as their clock cleaned.

-Night-time generally presents a higher risk for roughly the same reasons as a secluded area does: cover. Not only are people harder to see in the dark, but there's less people awake to see them, meaning that their chances of uninterrupted success are higher.

-Any area with just a few entrances and exits with little room to hide (such as an alleyway) makes a wonderful ambush point, so be wary of any strangers attempting to lead you through such a place and take pains to avoid these potential traps if you can.

- The vast majority of break-ins occur while nobody's home, since 'professional theives' generally aren't seriel killers, and vice-versa. For the most part, a theif would just as soon bolt for the nearest escape as he would deal with a rightously furious home owner.

- Listen to your gut- it's usually right. If an area gives you a bad feeling, it's probably for a good reason, and you should linger there as little as possible. If someone gives you the heebee-jeebees for no apparent reason, do your best to avoid them- if they're innocent, they'll get over it in no time and probably forget all about it by the end of the day, and if they're not, then you've saved yourself a world of trouble.

- Avoid standing out: They've got to pick someone, and people generally look at neon signs before the standard cardboard window signs, if you get my drift. If you're in unfamiliar or known dangerous territory, remain confident and maintain a driven, solid state of mind, but try to keep a lower profile than you normally would and take no steps to stand out. People who are quick to anger or other emotions, or are very prone to being outgoing are possibly the most common victims in some crimes.

- Helping: Preying on do-gooders is a classic criminal strategy. If someone comes to you desperately asking for a ride in your car or to come with them to help, take them seriously and advise them in a loud enough tone for others around you to hear that you're "dialing 911 for you right now". If you're not in a public place or in your car, remain where you're at and keep the doors locked and windows rolled up while you call for 911. If they're being honest with you, they'll probably appreciate the help, and if they're not, then you've just thrown the biggest monkey wrench possible in their plan.

-You are what you look: If you look calm, collected, and confident, not only will other people believe you are, but you'll begin to believe it too. It's important to maintain a look and act of cool, collected confidence in public, in riskier times and areas, and even in the face of danger because you'll be much harder to view as a prey item. Not only will you deter predators in general, but you might even be able to squash a violent situation in its socks by having the confidence to not get drawn in to the turmoil they're trying to create.

-Isolation: Lone individuals are easier targets to violence than groups of people. Try to always travel with at least one other person that you know well when going through a dangerous or new area. If someone attempts to isolate you with invitations to something, requests that you come over or come help, or tries to get in between you and your buddy to lead you in a new direction either physically or persuasively should be sternly, but politely, resisted.

- Loudmouth or dangerous?: Sometimes it's hard to tell when people are serious or when they're just shooting their mouths off. Someone who's just angry, doesn't necessarily want to fight, and is more putting on a show or display that 'ROAR, I'M MAD' will be red faced, screaming or yelling loudly, and will experience a complete inability to stop waving their hands around. The best policy is to just let them win, give them a way out that allows them to save face instead of getting sucked into their absurd righteous fury right along with them. The people you should genuinely worry about will generally be paler, more deliberate and in control, will say fewer words, and may keep their arms down by their sides with a slight inward bend at the elbows and balled fists or clenched hands.

The First Step: Certainly, violent crimes are some of the worst things that can ever happen to anyone, and the aftershocks of a single violent crime may be felt by many more people than just the victim and for many years after the crime itself. While it's true that there are times in which a firearm or weapon may be a useful tool in responding to an ongoing crime, and it's true that allocating extra funds to better staff and equipment law enforcement departments will help keep crime in check, it's an unfortunate fact that we in America have allowed ourselves to believe that responding is the only effective method of dealing with crime. The truth is that prevention is, at its worst, as effective as response, and infinitely more effective at its best. The truth is that response, at best, will not stop a crime from happening in the present- only stop a future or further crime from occurring. This noted, prevention should be your first step in dealing with the threat of crime. A lot of people have a misconception that they'll have to fork over a lot of cash- a lot more than it costs to keep their skill up with or purchase a new firearm-, but most prevention methods are largely a one-time cost, and some cost nothing at all! Some examples of one-time costs include jam-bars for sliding glass doors, shatter-proofing lamination for windows (handy for both keeping out crooks and darn neighbor kid's baseballs), dead-bolt locks for external and safe-room doors (because they'll much more readily resist a solid kick than your knob lock), solid doors, good jimmy-proof locks on your windows, a bolted-down safe (preferably fire and maybe even water-proof, making an excellent place to store valuables, small firearms, and personal documents that could be used for identity theft. Note that it MUST be bolted down, or any potential thieves will just use it as a convenient carrying case), and a combination-locked key box for your spare (see: Uh-oh) house key. Some examples of 'free' prevention are not leaving a ladder accessible in your yard(s), locking up before going anywhere, having a friend/neighbor/professional give you an honest review of your current level of security, adopting a dog (you don't need an attack dog- even a small yapadoodle can make all the difference because they'll notice people outside when you won't and, if they've lived with you long enough, can have an uncanny ability to know when something's not right), requesting the city install street lamps in front of or near to your house if they're not already there, reporting any unusual or suspicious activity to your local police department or sheriff's office (this is a big one, since a lot of violent crimes can take a surprising amount of preparation), requesting that your neighbors take your newspapers/mail in or house-sit for an hour or two a day if you're going out of town, planting spiney or thorny shrubs near a potential weak-point in your security, locking your car doors when you go in, and keeping most of your plant-life trimmed and well away from doorways.

Another really great thing you can do for prevention is to get active in your community- go and ask your local law enforcement office (or an officer who's got a little bit of time on their hands) what some of the current problems in the community are and what they would recommend for preventing or altogether stopping it. Also, start a neighborhood watch- get together with a few nearby families, set safety goals and parameters with each other (Such as "There shouldn't be ANYONE in my house between 2-4PM unless me or someone else from the family is there" or "We always go out for dinner on friday nights, so that's when our house is the most vulnerable"). Another great thing to do is to, again, designate a safe room and/or work with a neighbor to make a plan in the event of a disaster. Finally, see if there's anything you can do to help local law enforcement with public education, such as hosting or contributing to school events or handing out information fliers.

Last, but certainly not least, in prevention is the technique of active scanning. Active scanning is normally something that's mostly used for motorcycling, but can be adopted and adapted to other areas of life, such as keeping safe from violence. What active scanning means is that while you are in an area, you keep your eyes, ears, and brain functioning constantly- you observe and take note of anything you can and everything you can; pay attention to anything that seems suspicious, a potential threat, or catches your eye while you continue to search for things you didn't notice before. The most crucial part about active scanning is combining what you observe to formulate what's possible, probable, and definite, and how to respond to each scenario. They teach motorcycle riders to constantly be searching for the next best escape/evasion route should traffic suddenly encounter hell, high water, or both. Employing the same policy when out and about could help you greatly in avoiding a violent situation.

Response: Is the last and least effective phase of countering violence. At this point, a violent act has already occured or has started. If you feel you may be subject to violence, now is the time to deploy a set of tactics that you should have, by then, planned out according to the resources available. The key is to stay calm, confident, and in control of yourself, even when you're not in control of your situation. What I recommend for most situations is to follow the same ladder of escalating force that law enforcement and military officers employ:

1. Soft verbal exchange: "Please stop," "don't do that," and other general, inoffensive deterrent words that let people know that you're not interested and not amused. These should be said in a cool or even cold, confident or firm tone of voice, otherwise they may be viewed as a sign of weakness and actually make things worse. Now might also be a good time to employ a bit of verbal judo (NOT VERBAL KARATE- that is slinging insults or returning anger to someone. It's is a surefire way to escalate a problem. Verbal Judo is about redirecting their verbal momentum from a negative to a neutral or positive through maintaining a calm, confident, collected demeanor both in stature, tone, and language- think like a police negotiator, you're trying to resolve the incident, regardless of ego. Empathy is an extremely powerful tool in verbal judo) to try and get an angry person to calm down and cooperate.

2. If the soft verbal exchange doesn't work or it's apparent that you don't have enough time to let it work, then you move to the firm verbal command. "Stop!" is a wonderful example of the firm verbal command. The command should be issued firmly and confidently with an almost parental stature- exactly as if you're telling a three-year-old not to touch the stove or to stop playing with matches. Done right, it exhibits a very high level of confidence that may give your assailant pause, and it should draw on the fact that everyone was, at one time, a child, and was given similar powerful commands by their parents at some point or another. If you know the assailant's name, you can add it to your command for even more efficiency. If you're in a public area, this can be where you start talking in a somewhat louder tone to try and draw people's attention in case things are about to head south. If you're sure that your life will still be in iminent danger, this is the part where, now that they're thrown off-guard, you run and dial 911 or, if they continue, you move to the next level.

3. Light contact: At this point, they've made physical contact with you or have attempted to do so. At this point, all doubts need to be removed and 911 should be dialed if at all possible. Now is the point where you'd react by taking control, either evading further attacks, getting them in a joint lock, pinning them to a wall, or make time for an escape by delivering a swift, spontaneous open palm to their face- enough to stun anyone for a second or two, which should be enough for you to escape, reach for a non-lethal device such as pepper spray, or otherwise take control of the situation (though retreating to a safe area is always recommended). This segment should be skipped if they are armed and retreat is not an option.

4. Heavy contact: At this point, all else has failed and your life is in immediate danger. Because you are under serious risk of death or disablement, all bets are off and all stops should be removed- gouge at their eyes, bite at their ears or nose, deliver a flat-palmed smack to their ear for a ruptured eardrum, kick or knee them in the groin- bite, claw, kick and scream, and if all else has absolutely failed, begin lethal force measures such as a firearm, a knife, or a firm blow to the front of their throat. This stage should be one of absolute last resort, and will only be justified in the eyes of the law if it is seen that you felt your life was in imminent danger with all other options extinguishd. Once the threat has stopped, you must stop as well- anything done to 'teach them a lesson' will be considered use of excessive force or worse, and will not bode well for you in the eyes of the law.

The particulars:

Rape: A horrific crime that can ruin whole lives, no doubt. A good way to greatly reduce risk of rape is to use a buddy system when going through risky areas, to public events, or to bars or clubs. You might also consider carrying pepper spray, a contact taser, or a so-called 'rape whistle' or 'rape alarm' with you as both deterrents and tools in escaping an attacker. Be verbally firm with any suspicious persons from a fair distance and set up a 'don't come any closer' bubble of at least ten feet, avoid secluded areas, unlit areas at night, or isolation. If you find yourself the imminent subject of rape, move straight to heavy contact, make as much noise as possible, and do everything in your power to scar and injure this person because your life is in very real danger. If all else fails and the act is done, while waiting for emergency responders, do NOT clean up. Most rape victims feel a consuming urge to shower and clean off after the rape, but the fact is that this destroys much of the evidence that would have proven valuable in catching the rapist.

Hold-up, stick-up, mugging, robbery, etc: Nobody likes being victimized, especially when you can stare your attacker in the face, but if they've got a weapon drawn on you, fighting back is absolutely the worst thing possible for you to do. Most experts agree that the smart thing to do is just to cooperate, hand over their demands, try to gather as many details as possible, and alert law enforcement as soon as you're safe. Whatever it is you've got that they want, it's not worth your life, and unlike you, it's probably replaceable. Preventing theft can be a bit hit-and-miss, but the best policy is to pay attention and take preventative steps. When you're approaching the ATM, look out for any unusual or suspicious persons, as well as places they could be hiding, especially since drive-through ATMs have become popular focal points for carjackings. Watch anyone approaching you without apparent reason carefully, paying special attention to their hands to see if they're not concealing a knife. If a stranger approaches you suddenly, a good idea would be to tell them "woah, that's close enough," at a distance of five to ten feet or so. If you are the subject of a carjacking, you may be tempted to drive off, but the problem most people encounter when they attempt this is either that they're shot at or, because their attention was on the robber, they almost immediately crash in their hurry- sometimes both! If you've been the subject of a robbery of any kind, particularly a home robbery, ignore the urge to sift through and pick up things, retreat to a known safe area and contact law enforcement as soon as possible.

Kidnapping: This is an especially dangerous crime that isn't unique to small children anymore. You should educate yourself and your children on the latest safety advice to prevent a kidnapping. Again, paying attention is important, as the kidnapper may 'case' or investigate a child several days before actually comitting the act. The most important factor in kidnapping, however, is early reporting. The sooner a kidnapping is reported, the greater the chance is that the child will be located. With today's interstate system, even a few hours of lapsed time between the actual event and the reporting thereof could drastically hinder efforts to find the kidnapped person. You'll need to stay calm and provide law enforcement officials with as much of the information they ask for that you can. If you find yourself being subject to abduction, understand that being captured means putting your life entirely in another person's hands, so fight like the devil to NOT get captured while you can- fight dirty, fight savage, use whatever you can get your hands on and make as much of a scene as you possibly can (even if someone doesn't intervene, it turns everyone there into a witness). Once you are captured, the best time to try and make your escape is as early as possible, since during that primary phase, the kidnapper has you under only less-than favorable temporary conditions. If your life is under immediate threat, however, the best thing to do is just cooperate.

Road Rage/ Belligerent Persons: It's inevitable that you're eventually going to mess up in traffic (The average driver makes 400 observations, 40 decisions and 2 mistakes every 2-mile span), so you should be prepared to handle the reality that some people just stone cold lose their minds over minor errors. If you're in a situation in which a driver can and does exit their vehicle to confront you, stay inside your vehicle, keep your doors locked, windows up, and communicate without the benefit of unmuffled sound. Stay calm, confident, and in control of yourself and your passengers- because you're the driver, make sure they understand that only YOU are to deal with the situation. You should not confront the angered person or return their anger, even if you're not at fault. Consider scribbling 'Sorry!' on a piece of paper and showing it to them through the windshield, as a study found that in the vast majority of cases, this simple tactic defused the angered driver. If they're inconsolable and will not calm down with time, or they begin to start attacking you or your vehicle, dial 911 immediately and follow the dispatcher's instructions.

When ya gonna call?

Just a quick aside- I'm working on finding more choice words, but if my proofreading has missed a profane word, please forgive it. Also, as to my background, I am an EMT-Intermediate '85', undergoing Paramedic training as of the time of this writing. I've decided to dedicate a blog specifically to providing what I'm quite sure are some fresh and valuable tips to you, the patient, on how to utilize the system in the US to its fullest. Please be aware, however, that when I speak of how a system operates, I speak in generalizations and operations can vary from locale to locale- thus, my statements may be inaccurate for your area. Please take the time to learn the details about your local emergency system. Also, if there are any questions, I'll do my best to address them within reason, so feel free to ask.

This first article is about when and when not to call for Emergency Medical Services (or more simply: 911, EMS, an ambulance, the paramedics, etc.). My reasons for choosing this as the first article- after a bit of debating between this one and 'A trip to the doctor's office'- come from my remembering that before my medical training, I really didn't know what the line was between what constituted an emergency and what didn't. I remember a few situations where I wondered to myself, in stalemate, whether or not I should call for an ambulance or not. In today's densely-packed society, the likelihood that any of you, if not all of you indeed, may encounter or, heaven forbid, have an emergency in the next few years is extremely high. Assuming that the rest of you are like I was, and couldn't actually decide between there being an emergency or not, I'm writing this so that you can be prepared and can properly identify an emergency early on and possibly save a life.

First, what constitutes an emergency? Well, there's quite a few answers, but here's a great rule of thumb: Any significant deviation from someone's normal status of existence. For example, if someone hasn't just had inexplicable and horrific chest pain their whole life, and they suddenly develop persisting and bad chest pain, you need to really watch them, because that's one major sign of an emergency. If a person who's usually pretty much like a normal person in the middle of the day suddenly starts getting confused, mentally 'slow', sleepy, and/or generally acting strange, chances are that it's an emergency and you need to call EMS. Here's a few solid guidelines of an emergency, along with explanations.

- If someone has had a persisting fever for three days OR has a fever over 103 F; that's 39.4 C for those of you who don't use Fahrenheit (see: Everyone). The reason for this is that it's an indicator of a very serious infection, be it viral, bacterial, or fungal. Also, the very high, persistent fever can be extremely dangerous to the brain and other body organs.

- If someone's having trouble breathing, especially if it's spontaneous. If they know what it is and can manage it with their own inhaler or other methods, then allow them to do so. However, stay attentive- if it doesn't resolve with self-treatment, and they're clearly having a lot of difficulty breathing (you can see their head moving back and forth from how hard they're working their chest muscles, you can hear loud wheezing sounds, they're leaning way forward, they can only talk to you one or two words at a time, you can see their nostrils flaring, you can see them using their neck/shoulder muscles to try and help them breathe, and ESPECIALLY if their lips start to turn blue) then you need to start picking up the phone. Stay nearby so that you'll know if the situation gets better or they stop breathing, in which case the dispatcher will be able to provide you with instruction on how to help until EMS arrives. Also related is if you find them not breathing or if they start choking. Call EMS IMMEDIATELY when you see that someone's choking (IE: Can't cough, can't breathe, can't talk, clearly struggling) because sometimes things like the Heimlich maneuver don't work and require more advanced interventions.

- If someone is completely unresponsive (meaning that you've tried to wake them by calling to them and that you've tried to wake them by pain stimulus such as pinching their fingernail against their finger) or is very lethargic or confused, particularly if it's clear that they shouldn't be. This should immediately start throwing red flags and cause you to start checking to see that they're still breathing or still have a pulse. If you can't stir them, or they look pale, sick, sweaty, or unusual in some other way, then you need to start dialing for an ambulance.

- If someone has a seizure. Of course, I'm referring to the classic Tonic-Clonic seizure that everyone immediately thinks of when you say 'seizure'. True, people have conditions that can induce seizures regularly, but they usually have medications that almost completely control it, so they shouldn't be having one in the first place. So, yes, call EMS. If they don't have epilepsy or other seizure-inducing conditions, then you should have absolutely no doubt whatsoever that it's an emergency and NEED to tell the medics about it when they arrive. Also, be careful to note if they hit their head on anything if they fell over. The reason seizures are such a big deal is that they can be an indicator of very serious underlying conditions, not to mention that they don't breathe at all during the extent of the seizure, so they could be suffering from dangerously low oxygen levels.

- If someone becomes suddenly confused or starts acting strange (particularly if they start acting drunk without actually being drunk) and it doesn't immediately resolve, you need to be reaching for that phone. Like seizures, it can be a sign of a very serious underlying condition that could be immediately hazardous to their health. Also similar would be if they spontaneously lose consciousness or fall out, even if they return to consciousness right away and especially if they hit their head on the way down.

- If someone has a new or sudden onset of severe, persisting (see: lasts more than a few seconds at a whack and clearly isn't something like muscle pain. If someone tries to pass off a very, very bad chest pain as indigestion, you need to remain skeptical about it, as denial is even considered to be 'classic' in the heart attack patient) pain, particularly in the chest and/or abdomen. There are a plethora of reasons for this, and almost all of them are very serious.

- If someone is found to be without a pulse and isn't decomposing (there are other ways to tell if it's far too late to resuscitate them, but those are better left to those trained to recognize it). Absolutely call 911, every, single, time.

- If someone starts vomiting or otherwise excreting blood in ways that they really shouldn't be (also, black, tarry, and sometimes face-meltingly bad smelling stool is a sign of a lower GI-bleed, which is also an emergency).

- If someone has been vomiting excessively for three days or more, thus unable to keep anything, even water, down. One day may pass, two days is on the fence and understandable if you call, three days should leave no question because now they're getting very dehydrated, first and foremost.

- If they've got an illness (like asthma or allergic reactions) that you're aware of and it's worse than you've ever seen it get before or it's getting to a clearly life-threatening point.

- Suicide threats should always result in a call to emergency services and should never -EVER- be shrugged off.

- If you're seriously debating on whether or not to call EMS, you should probably call. You can always ask the dispatcher to cancel the response if things get better.

- Trauma is a bit trickier to deal with, so bear with me. If they fell from three times their height or more (only twice their height for children), hit anything on the way down, hit their head/neck, or are clearly injured from the fall, who ya gonna call? Also, any car crash should always result in EMS being called (Unless all occupants assure you otherwise or the crash was clearly minor with minimal, if any, damage), particularly if the cars struck going in opposing directions. If someone hits their head hard enough to create a lump, cause bleeding, or cause them to lose consciousness, call EMS and insist that they seek treatment (mind that you can't hold them there because that's false imprisonment). If they were involved in an accident and broke a bone, the car rolled over, another involved person was killed, another involved person was ejected, or the cars or plainly mangled wrecks, it's time to call. If an eye was put out, call. ANY motorcycle crash needs to have EMS called. If anything was amputated, call. If they're bleeding and you can't immediately control it, they've lost/are losing a lot of blood really quick, have extensive injuries, or are spurting bright red blood, call. If they were burned (excluding all but the worst sunburn) over at least 1/8 of their body or had been on fire, had been inside of a structure while it was on fire, are still on fire, have burns around their lips, have a hoarse voice after being involved with a fire, or have burns with blackened/white and waxy charred skin, you need to call. If someone complains of neck or back pain after an accident or injury, you NEED to call.

- All of this goes doubly sensitive for children and elderly.

- If you smell alcohol on their breath but they're giving the impression that they may be having a medical emergency, such as having a large bruise on their head or stating that they're having chest pain, it's just safer to assume it's not the alcohol talking and call. Now, understand that it can be very difficult to tell if an intoxicated person is having an emergency or not because alcohol can mask a lot of signs and symptoms very well, as well as causing the person to answer questions inappropriately, so just be safe rather than sorry.

- If you notice a lot of people all passed out or behaving unusually in a certain area (ex: you walk in the mall to see everyone slumped onto the floor, everyone passed out or acting strangely inside of a neighbor's house, etc.), then you both need to get out posthaste AND call, because there's a very good chance that there's a hazardous materials incident (carbon monoxide in the case of the 'neighbor' example) happening. Also, call right away if there's an explosion of any sort that wasn't supposed to happen, if a tanker truck has overturned or crashed, if you notice any unusual clouds or smoke leaving a structure or vehicle, or any strong unusual smells- especially if you're in a location that handles chemicals, such as a home utility store.

- If they tell you to call 911, don't you even dare second-guess them. Do it.

- Pregnant woman in full, strong, late labor. EMS has the tools to help safely deliver a baby and handle any complications that may ensue. A taxi driver or a department store does not.

I know it's a lot, and I don't at all expect you lot to memorize the whole list, but if you even take a little bit away from this, it's going to help a lot.

Also, a quick note of the Dont's.

- Don't call EMS to take you to your doctor's office. We are EMERGENCY medical services, we do not take people to their doctor's offices. If you fake a problem- thinking it'll get you to your doctor's- you're going to the ER anyway. Not only do you put undue strain on a system that's spread thin in a lot of places to begin with, but you put other people's well-being at risk. This also goes for trips to the pharmacy and to visit relatives in the hospital as well as anything else of that sort. Just call a cab, they're at least $500 cheaper and you won't be putting anyone else's life at risk by stretching a thin resource even thinner.

- Don't call us because someone tapped your bumper and you think you're going to get more insurance money that way. People actually do this, and see above for why not to. Besides, it makes you look like a drama whore, and it makes you a drain on the system, both financially and logistically. If you're honestly in pain- honestly in need- that's fine, that's what we're here for. Otherwise, find some other way to abuse the system.

- If you need non-emergency transport to a specialized facility, don't call 911. Many ambulance services will have private, non-emergency numbers which you can use to schedule a non-911 truck to take you.

- We are not a rolling pharmacy. We cannot (excepting the UK's Paramedic Practitioner) hand out something for your headache or fever because we can't prescribe medications. There are a number of reasons for this policy, but the most important of them is because we don't want to disguise the symptoms of what could be a serious underlying condition and end up inadvertently causing more harm by allowing the condition to continue unrecognized.

- Don't turn away EMS because you're stubborn. If you're having an emergency, you need to go. Many a person has made themselves beyond help because they tried to tell themselves that their crushing chest pain was just indigestion for a good three days before finally admitting, well past any window for recovery, that it's something else. I understand money's tight these days, but you can't earn, save, or spend money if you're dead.