They go in after the police respond to situations stemming from violence, explained Brad Morris, deputy chief for the Walla Walla Fire Department.
And only after the police.
"We're not going to be able to help people if we become part of the problem."
Waiting for the green light from officers is the way first responders to a medical emergency can stay safe, or even know if they are responding to a possible gang incident, he added.
"We don't know if it's gang related a lot of times. There might be a lot of people involved, but that's not always an indicator."
In reality, arriving at a domestic violence scene offers more potential for getting hurt, Morris noted. "That's where you're not sure what you're getting into."
Typically his paramedic crews will set up, or "stage," a block or two away from the scene of, say, a shooting or stabbing.
"It's drilled into us at school. We wait for the scene to be secured," he said.
Then it's right into the thick of things. "We're finding a lot of carnage at times, especially with multiple victims. We're busy right off the bat, trying to find wounds, what kind. If it's gunshot, what caliber."
And no matter the nature of an incident, it doesn't change protocol of treatment, he added.
The patients can be combative and are almost always scared, Morris said. As well, "There can be a lot of emotional things going on from siblings, parents, girlfriends. Sometimes it's a challenge to keep family at a distance."
While Morris and his staff can't speak to a rise in gang violence -- "We don't even always know or find out until later," he explained -- they do know a situation with a number of injured people stresses the resources of a small town like Walla Walla.
"In any given day, our regular staffing on ambulances is two front-line ambulances, one from each end of town. If we have a third emergency call, we have to take someone off (a fire) engine," Morris said.
"Anything like a mass casualty situation, take that gang fight -- if we had other calls come in, they would have had to wait. And it's not just us, it's the ERs. You get that many critical patients at once, it's going to tax their systems, too."
Sheila Hagar can be reached at email@example.com or 526-8322. Check out her blog at blogs.ublabs.org/fromthestorageroom.