# Psych Patient Chaos



## EmergencyMedicalSike (Oct 29, 2017)

There was a crew who had our unit rig before us and they ran a psych transfer call just like any other. Except this particular patient slipped through the Velcro restraints and escaped through the back. The crew said he was O2 satting at 94 so 2lpm via nasal was given. This guy ran off with our O2 cylinder and cannula and the crew didn’t even replace it at their EOS and our supervisor got heated at my partner and I when we told him we had no O2 cylinder on the gurney. In the end, everything was worked out but man what a situation


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## DesertMedic66 (Oct 29, 2017)

So he was able to get out of 2-4 Velcro restraints without making too much noise, undo several seatbelts on the gurney, unstrap the O2 bottle from the gurney, and then stand up and open the door all without the crew being aware of the issue? Sounds like that crew needs some education...


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## Jim37F (Oct 29, 2017)

Pt was probably only on 2 point vs 4 point restraints, and the velcro was probably improperly applied and/or simply too loose....and was probably only had one or two seat belts applied instead of the full shoulder restraint system......I seriously have no clue why, but even after seeing policy updates and even supervisors doing random checks at hospitals when units come in, I saw lots of crews actively choose to not follow those policies for......reasons? Like you have to drag some crews kicking and screaming to actually apply the 4 point shoulder restraint seatbelts even though that was 100% mandatory for all patients (the exception to policy was actively interfering with treatments but lets face it, how often is that a legit concern where you can't do a 12 lead or whatever because there's a couple straps nearby...) Oh yeah, the attendant was probably sitting in the jump seat behind the gurney, likely on their phone and/or napping instead of paying attention to the psych patient....Which in any case, only further reinforces your point Desert:


DesertMedic66 said:


> Sounds like that crew needs some education...



But yeah, why you would get flack for the previous shifts failures is beyond me....unless you never noticed the missing O2 bottle until halfway through your own shift when you went to go use it and it wasn't there and you either filled out a check sheet at the beginning of shift stating it was good and it really wasn't 'cuz you didn't actually check (another thing I saw more than a few people do, fill out the rig check sheets at the beginning of shift whilst sitting on the couch inside station....) and/or didn't bring it up to your supervisor right away at the start of shift regardless of the paperwork....if that's the case, then yeah, you OP effed up and deserved the tongue lashing....if not (you did a proper check out and immediately called your Supe) then there's absolutely no reason the chew you guys out because then you didn't do anything wrong


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## EmergencyMedicalSike (Oct 30, 2017)

Jim37F said:


> Pt was probably only on 2 point vs 4 point restraints, and the velcro was probably improperly applied and/or simply too loose....and was probably only had one or two seat belts applied instead of the full shoulder restraint system......I seriously have no clue why, but even after seeing policy updates and even supervisors doing random checks at hospitals when units come in, I saw lots of crews actively choose to not follow those policies for......reasons? Like you have to drag some crews kicking and screaming to actually apply the 4 point shoulder restraint seatbelts even though that was 100% mandatory for all patients (the exception to policy was actively interfering with treatments but lets face it, how often is that a legit concern where you can't do a 12 lead or whatever because there's a couple straps nearby...) Oh yeah, the attendant was probably sitting in the jump seat behind the gurney, likely on their phone and/or napping instead of paying attention to the psych patient....Which in any case, only further reinforces your point Desert:
> 
> 
> But yeah, why you would get flack for the previous shifts failures is beyond me....unless you never noticed the missing O2 bottle until halfway through your own shift when you went to go use it and it wasn't there and you either filled out a check sheet at the beginning of shift stating it was good and it really wasn't 'cuz you didn't actually check (another thing I saw more than a few people do, fill out the rig check sheets at the beginning of shift whilst sitting on the couch inside station....) and/or didn't bring it up to your supervisor right away at the start of shift regardless of the paperwork....if that's the case, then yeah, you OP effed up and deserved the tongue lashing....if not (you did a proper check out and immediately called your Supe) then there's absolutely no reason the chew you guys out because then you didn't do anything wrong


Noticed the O2 cylinder was missing during start of shift checkout. Radioed supe and he thought we were in the middle of a shift.


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## EmergencyMedicalSike (Oct 30, 2017)

DesertMedic66 said:


> So he was able to get out of 2-4 Velcro restraints without making too much noise, undo several seatbelts on the gurney, unstrap the O2 bottle from the gurney, and then stand up and open the door all without the crew being aware of the issue? Sounds like that crew needs some education...


We usually use 2 wrist restraints. Ankle ones are only if the pt is combative as hell. Also some of our crews don’t bother fitting the cylinders in the pouches for god knows why


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