# 5150 Hold



## ThatEMTGuy (Nov 17, 2014)

I'm not sure if this is the right place for this thread, but can someone explain to me what a 5150 hold is, and how it works on EMT's. On that note, what is a 4 point hold and 2 point hold? Thank you, and sorry if this question was redundant.


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## DesertMedic66 (Nov 17, 2014)

5150 hold is a 72 hour mandatory psych hold. It means that the patient has to be evaluated within 72 hours. 

Pretty much for us if someone is placed on a hold they "loose" the ability to make medical decisions for themselves. 

2 point restraints mean only 2 of their limbs are restrained. 4 point means all of their limbs are restrained.


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## NomadicMedic (Nov 17, 2014)

A "5150" is the California code for a 72 hour psychiatric evaluation hold, but the term 5150 is often used to describe any psych patient transported by EMS.

"Section *5150* is a section of the California Welfare and Institutions Code which authorizes a qualified officer or clinician to involuntarily confine a person suspected to have a mental disorder that makes him or her a danger to themselves, a danger to others, and/or gravely disabled."

4 points and 2 points are restraint arrangements. 4 points is legs and arms restrained, 2 points are usually just arms. Many agencies that transport psychiatric patients that have the potential for violent behavior have a soft restraint system installed on the gurney.

Always know your protocols and company policy regarding restraints before using them, and be kind to psych patients. They're often treated with derision and ridicule.


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## ThatEMTGuy (Nov 17, 2014)

DEmedic said:


> A "5150" is the California code for a 72 hour psychiatric evaluation hold, but the term 5150 is often used to describe any psych patient transported by EMS.
> 
> "Section *5150* is a section of the California Welfare and Institutions Code which authorizes a qualified officer or clinician to involuntarily confine a person suspected to have a mental disorder that makes him or her a danger to themselves, a danger to others, and/or gravely disabled."
> 
> ...


oh okay thank you. That was very helpful.


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## ThatEMTGuy (Nov 17, 2014)

DesertEMT66 said:


> 5150 hold is a 72 hour mandatory psych hold. It means that the patient has to be evaluated within 72 hours.
> 
> Pretty much for us if someone is placed on a hold they "loose" the ability to make medical decisions for themselves.
> 
> 2 point restraints mean only 2 of their limbs are restrained. 4 point means all of their limbs are restrained.


Thank you so much! I get it now! I was confused on the whole concept. It's so much clear.


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## Ewok Jerky (Nov 19, 2014)

3 criteria for a 5150 hold. 1) danger to self 2)danger to others 3) gravely disabled.

A 5150 does not have the right to refuse transport.  While on the hold, they are not legally capable of making decisions. This is important for you because you are transporting them, potentially against their will.

I've had to explain this to a number a patients who haven't had it explained to them adequetly by the staff when I show up with the gurney or when they aren't being sent to the facility of their choice.

Make sure you understand not only your policies for restraints, but your regulations, and most importantly understand how your restraints work.

Always check the paperwork for 5150 form filled out signed and dated.


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## JPINFV (Nov 19, 2014)

Two quick things to add. 
1. 5150s are due to psych disorders only. It's not the mechanism to force transport when the patient is altered. Too many people think that the dementia patient needs a 5150 to force transport. 

2. The patient on a 5150 still retains the right to refuse treatment not related to evaluation and emergency treatment (I.e. long term psych meds).


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