# Punch a medic - it is not that expensive.



## medic417 (Mar 10, 2012)

http://www.ems1.com/safety/articles/1249969-Drunk-high-school-student-punches-Calif-medic/


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## DesertMedic66 (Mar 10, 2012)

Welcome to California. If I get punched by a patient I am swinging right back.


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## abckidsmom (Mar 10, 2012)

firefite said:


> Welcome to California. If I get punched by a patient I am swinging right back.



Not me, I'm a sissy when it comes to fighting.  I duck and restrain.


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## Veneficus (Mar 10, 2012)

A citation is more than anyone who ever hit me at work ever got.


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## Sasha (Mar 10, 2012)

firefite said:


> Welcome to California. If I get punched by a patient I am swinging right back.



If they're swinging because of dementia, cva, diabetes etc you're going to swing back? Really?


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## DesertMedic66 (Mar 10, 2012)

Sasha said:


> If they're swinging because of dementia, cva, diabetes etc you're going to swing back? Really?



For those patients who are aggressive due to medical issues my partner and I (fire and LEO) will take them down to get them under control. If I have a psych patient swing on me and hit me then yes I will swing back followed by a take down to gain control of the scene.


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## Veneficus (Mar 10, 2012)

Psych is a medical issue.  ?????

What in your mind is the difference between a patient with a heart problem, lung problem, liver problem, or brain problem?


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## DesertMedic66 (Mar 10, 2012)

Veneficus said:


> Psych is a medical issue.  ?????
> 
> What in your mind is the difference between a patient with a heart problem, lung problem, liver problem, or brain problem?



In my poorly worded post I never said that psych is not a medical issue.


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## Sasha (Mar 10, 2012)

Why would you swing back then take down?


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## Veneficus (Mar 10, 2012)

Just so I understand, you do or do not respond to aggresive psych patients differently from aggresive "medical" patients.

From your post it looks like you treat the 2 groups differently?


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## abckidsmom (Mar 10, 2012)

firefite said:


> For those patients who are aggressive due to medical issues my partner and I (fire and LEO) will take them down to get them under control. If I have a psych patient swing on me and hit me then yes I will swing back followed by a take down to gain control of the scene.



I have had plenty of patients take swings at me, but very few connect. 

We always, always just took then down to the ground and subdued them, never hitting them.  

Why would you ever respond to a patient hitting you by hitting them?  It's not necessary, inappropriate, and unprofessional.

And what Vene said. Psych=Medical. Out of your mind for any reason is just out of your mind. Even for intoxication. Subdue, not assault.


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## DesertMedic66 (Mar 10, 2012)

Veneficus said:


> Just so I understand, you do or do not respond to aggresive psych patients differently from aggresive "medical" patients.
> 
> From your post it looks like you treat the 2 groups differently?



All depends on the patient and what events have occurred.


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## Veneficus (Mar 10, 2012)

abckidsmom said:


> It's not necessary, inappropriate, and unprofessional.



and in some instances illegal. 

I would encourage you to go to the DT4EMS website at the very least, and do some more research into the topic.

If there is a report of patient abuse at the hospital, there will be an investigation.

There are rules governing the use of force on patients. Always do your best to be well within your bounds.


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## JPINFV (Mar 10, 2012)

Without knowing what the exact penal code section the suspect was  charged with, it's impossible to know what the penalty is. A "citation"  ("notice to appear") can be issued in misdemeanors, however this is most  common with misdemeanor traffic citations. As such, any speculation  about what the penalties may or may not be are just that. 
 California Penal Code 241(c) covers assault against a paramedic.
 California Penal Code 243(b) covers battery against a paramedic. 

 Assault or battery against a paramedic in California afforded the same penalties as if committed against a police officer.


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## EFDUnit823 (Mar 10, 2012)

It is a fine line between “restraining” and “assaulting” back. Where I am from, most calls that have a high potential for aggressive patients an appropriate law enforcement agency will be simultaneously dispatched. Of course, there is always that time where you have to make the call to keep your distance and request law enforcement. My personal opinion, I believe most all situations can be defused based upon our reaction to the situation. However, in Indiana if an individual does decide to assault EMS personnel we have IC 35-42-2-1 which makes that assault a Class D Felony.

EDIT: In Indiana, it is actually a Class B Misdemeanor if no bodily harm is done (A person who knowingly or intentionally touches another person in a rude, insolent, or angry manner), and a Class D Felony if bodily harm is done.

If you wish to look up the law in your State, this may help;

http://www.ena.org/IENR/Documents/State Survey - Criminal Laws - Misdemeanor and Felony.pdf


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## JPINFV (Mar 10, 2012)

The two California Penal Codes that I listed don't designate whether they are felony or misdemeanors. However since neither result in imprisonment over 1 year, I think they're both misdemeanors. The reality is how long would you want a drunk 15 year old to be imprisoned for?


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## johnrsemt (Mar 11, 2012)

I would want a drunk 15 year old who commits assualt and battery on me to be imprisoned for as long as the law allows.  Same as if he got behind the wheel and killed someone.

   Why would you want other people to see that if they assualt you, they get a slap on the wrist?   If it is a diabetic person, or similar that is different due to the fact that they did not do it on purpose:  But a person does not "accidently" drink themselves to the point of being physically abusive.


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## Veneficus (Mar 11, 2012)

johnrsemt said:


> I would want a drunk 15 year old who commits assualt and battery on me to be imprisoned for as long as the law allows.  Same as if he got behind the wheel and killed someone.
> 
> Why would you want other people to see that if they assualt you, they get a slap on the wrist?   If it is a diabetic person, or similar that is different due to the fact that they did not do it on purpose:  But a person does not "accidently" drink themselves to the point of being physically abusive.



That is why administration of the law is in the hands of a judge.

The plantfif's desire for vengeance must be weighed against the threat to society and the pleas of mercy from the perpetrator in a fair and balanced way.


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## Tigger (Mar 11, 2012)

firefite said:


> For those patients who are aggressive due to medical issues my partner and I (fire and LEO) will take them down to get them under control. If I have a psych patient swing on me and hit me then yes I will swing back followed by a take down to gain control of the scene.



Why not just skip the whole hitting the patient thing and just skip to the takedown and restrain part? I have a hard time coming up with a time in which it's appropriate to hit a patient unless your life is imminent danger. Unless you knock the person out you're just pissing them off even more, making it harder to gain control. And if you sucker punch a psych transfer unconscious, you may have some explaining to do.


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## EFDUnit823 (Mar 12, 2012)

johnrsemt said:


> I would want a drunk 15 year old who commits assualt and battery on me to be imprisoned for as long as the law allows.  Same as if he got behind the wheel and killed someone.
> 
> Why would you want other people to see that if they assualt you, they get a slap on the wrist?   If it is a diabetic person, or similar that is different due to the fact that they did not do it on purpose:  But a person does not "accidently" drink themselves to the point of being physically abusive.



Ok, I must respectfully say that you are contradicting yourself here and I will explain why. But first, I do agree with the fact that there must be consequences for assaulting EMS personnel and they should be enforced. However, this should be on a case by case basis maybe even left up to the EMS person who was assaulted to press charges or not.

Now, you say you “I would want a drunk 15 year old who commits assault and battery on me to be imprisoned for as long as the law allows.” Ok, cool, I can understand where you are coming from. However, then this must apply to EVERYONE, including the diabetic patient. Why? Think back when you were first taught about “implied consent.” When generalizing, there are only a few things that fall under implied consent, one of them being an altered mental status e.g. intoxicated person. With that, how can we say that because of their altered mental status we are justified with “forcing” treatment on them which may/or may not involve restraints, yet in the same breath, claim that they were c/a/o enough to be punished for their actions in said state of mind? Keep in mind; some states the severity of their punishment can be pretty harsh. So, why include a diabetic (or other) person with an intoxicated person you may ask? Granted, when someone is intoxicated they more than likely (some would say obviously) consumed the substance to get them to that state. Like you said, “…a person does not ‘accidently’ drink themselves to the point…” However, let us consider the “medically exempt” example you gave. I am not going to claim to know your experiences with diabetic emergencies, but with mine, when investigating the “events leading up to” I always seem to find they essentially brought the diabetic emergency onto themselves. A lot like the intoxicated person who took the substance.

With that considered, why would we want to crucify the one and forgive the other, especially a fifteen year old? So, they made a bad choice! I am sure everyone here were perfect angels as teenagers. Why take away the chance from this child to “learn” from their mistake only to replace it with the likely hood of destroying the rest of their life?


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## DrParasite (Mar 12, 2012)

so you treat the following situations differently if they take a swing at you?

drunk a hole

violent edp

drunk kid

drunk former marine or football player

violent kid

combative accidental OD former linebacker and current police officer

PCP user who is running around naked and doesn't want to be restrained

and then go into:

diabetic AMS

CVA AMS

combative overdose

user of recreational pharmaceutical substances

EDP who are just off their meds

and then you get involved in the domestic where the aggressor doesn't want you to help the victim, and he will eject you from his property if you don't leave willingly

for me, anyone who takes a swing at me is getting restrained.  by me if needed, and by the cops when they get there.  anyone who assaults an EMS worker should be charged just as if they assaulted a cop or firefighter.


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## EFDUnit823 (Mar 12, 2012)

DrParasite said:


> so you treat the following situations differently if they take a swing at you?....for me, anyone who takes a swing at me is getting restrained.  by me if needed, and by the cops when they get there.  anyone who assaults an EMS worker should be charged just as if they assaulted a cop or firefighter.



Not sure if this is a response to my post specifically, toward the OP, or just in general. Considering it is after mine, I will assume you are asking me.

“so you treat the following situations differently if they take a swing at you?”- DrParasite

Absolutely! Anyone who has been doing this for any length of time will confess that each situation is unique in and of itself, and should be treated as such. Whether, I am encountering any potentially hostile situation through the fire department or ambulance service, I am not there to kick *** and take names. Though I have and will assist with restraining as needed, I firmly believe one can be successful with situational awareness and have a good idea how to handle a given situation. Many of the examples you gave should be left to the police department making the “scene safe,” before just running in to a potentially hazard situation. Albeit, if I allow myself into a situation where I have been swung on, then yes I agree, whether they are eight or eighty they will be restrained.

“anyone who assaults an EMS worker should be charged just as if they assaulted a cop or firefighter”- DrParasite

I agree one hundred percent! My point is that charging people for “attacking” EMS personnel should be left up to the EMS person who was attacked instead of just a non-exception default. In other words, left to a case by case basis. Why? We should have enough medical discernment to judge between a would-be attacker just being violent or a victim of their condition.

Whether I am clocked in as a firefighter or an EMT, my job does not entail law enforcement. If at any time I need the services of the third agency in “first-responding,” i.e. police, then I have a radio to get them there. In my opinion, the only exception to not waiting for law enforcement is if I, or some else, is in danger from being hurt by the patient.


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## Craig Alan Evans (Mar 12, 2012)

In Va assaulting a firefighter or paramedic is the same as assaulting a police officer and carries a minimum of 6 months in jail. The judge cannot reduce the sentence for any reason.


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## johnrsemt (Mar 12, 2012)

In response to EFDunit823:   I have quite a lot of experience with Diabetic patients;  and while you can argue that the diabetic who takes their insulin but doesn't eat brings it on themselves:     you have to also say that the one that eats what they are supposed to, takes their insulin and oral meds like they are supposed; goes to bed at the same time (within 15 minutes) and has a 2am snack next to the bed (same snack, and amount every night), with an alarm set so that they wake up and eat it:   but wakes up at 0800 with a BGL ranging from 28-200; it would NOT be their fault if they were combative.

   The above example is my mother:   They can't figure out why her body does that to her.   Good thing is that she just gets lethargic but not combative.

   Your right if it was a patient who doesn't take their meds because "I don't want to" or "cause I didn't have time.  Or takes their insulin but doesn't eat due to the same reasons:  yes that is the same as a person who drinks.   But someone with a metabolic condition that makes them combative or due to a CVA;  that is different; and I would treat it differently; and I have treated it differently when it comes to charges


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## Veneficus (Mar 12, 2012)

I think we are losing sight of intent.

In many states I am aware of, including my home, assaulting a EMS provider or firefighter is the same as assaulting a police officer. 

But before we decide to throw everyone in prison, I think it is important to understand the intent of such law.

A key phrase that comes to mind is "knowlingly and with willful or malicious intent."

Psych patients, diabetics, etc might actually assault and in some cases batter healthcare providers.

It is not knowingly, willfully, or malicious. Clearly we should not reactively bring criminal charges against them.

A drug OD, alcoholic, etc is really now different. 

Now some may argue that nobody forced them to drink, use drugs, etc. But that assumes there is no physical addiction. Because once somebody requires a substance to homeostas, it is no longer a choice, it is required for life.

Once upon a time, the idea of making it a crime to assault a police officer comes from the idea that an assault on the King's soldiers is an assault on the king. 

If you were brazen enough to use violence against those with a duty to preserve the peace and order of society, you were a threat to society at large.

That was culturally extended to those with the duty to provide care or protection to society.

Because of the nature of healthcare, healthcare providers will often come into contact with people whos minds are not functioning properly. 

That is inherently dangerous.

Unlike law enforcement however, so little (for all intents and purposes none) time is spent educating or training medical providers for these dangers.

Only a few places spend money on protective equipment, and even fewer providers utilize it regularly. 

Actually I was on the job for more than a year before I was given any education or training on the use of force, what was allowable, etc. To this day I have received no medical based training in the techniques.

The only reason I got the education in it I did is because two providers at an agency near where I worked killed a patient restraining them. (sandwitching the pt between 2 backboards and sitting on top as the story goes)

Both were lucky not to be convicted of anything and both were fired.

Back to the law. 

It is becomming more common in the whole world to recognize that people not in control of their minds are not always criminally responsible for their actions under a variety of circumstances.

Most criminal justice systems where I have worked are simply too overwhelmed to spend time and effort on "he said, she said," no lasting damage cases.

Taking a punch from an altered patient is quite a different story than somebody who picks out a police, fire, or EMS provider as the target of violence. The later being when the intent and full force of the law is applied consistently.

I encourage everyone involved in patient care to do what they need to in order to receive training and education before any incident occurs.

Do not assume the law protects you, you are within your defensive rights, or that word of mouth in your agency is sufficent training.

As I said before, it is not only possible to be called out for acting in contra to professional standards, but it is possible that your response is also a crime.


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## EFDUnit823 (Mar 12, 2012)

@ Veneficus  Bravo and well said sir!

@ johnrsemt Thus the need to consider all situations on a case by case basis, instead of a “fry them all” just because they fall under a certain category.


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