# treating a criminal patient



## Striving (Jul 29, 2012)

I'm new to EMTLife so please excuse me if this seems like an inappropriate topic to discuss. 
I am wondering if any of you have had a pt that you must treat and transport that has committed a terrible crime against another (rape, murder,ect) and if it left you with any negative feeling after. I know that everyone that gets into EMS wants to help people, and WILL provide the same amazing care to each pt no matter what. that said I am curious to know if helping to save the life of a criminal feels any different then helping save the life of an innocent.

For instance, a few years ago when my little brother was in the hospital I saw a man being rushed through the bay doors surrounded my cops and medics running full speed. We later found out (my bro unfortunately shared a surgical recovery room with him) that man was angry about being fired, had come back to the office and began shooting as many people as he could until cops arrived and he unsuccessfully tried to kill himself. I saw the same sense of urgency on the medics faces that brought that guy in, as all the other medics with trauma cases I saw roll past us that morning.  
So am I over thinking this? or do these kinds of cases actually have an effect on the emergency medical providers?   I DO NOT mean level of care provided, I know care provided will always be the same no matter who the pt is or what they might have done. 

I would love to hear any of your thoughts on this matter.


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## LondonMedic (Jul 29, 2012)

Striving said:


> I know that everyone that gets into EMS wants to help people, and WILL provide the same amazing care to each pt no matter what.


:rofl:



Anyway, in as much as there's a serious question in there; you just crack on. I see up to thirty patients in a 10 hour shift. I have not go the time and effort to give more than a flying :censored::censored::censored::censored: about what any of them may or may not be like.


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## Medic Tim (Jul 29, 2012)

I know it can be very difficult at times to remain professional but we need to treat every pt to the best of abilities regardless of the circumstances surrounding what happened or their past. One of my first calls was for a male with hiv and Hep B who raped a 6 yo and then tried to commit suicide. He took a razor blade and cut himself from earlobe to earlobe. It can be very tough on some knowing the circumstances. I separate myself from it as much as possible. I have been on many bad calls or whatever you want to call it but besides the main details I don't remember much like names. Some of my partners know the names and full story of the bad calls they have been on.


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## NYMedic828 (Jul 29, 2012)

9.9/10 times if I have a shooting victim at work, it didn't occur because they were an upstanding citizen in the wrong place at the wrong time.

My job is not to care about the situation its to treat the patient. (as long as it is safe for me to do so)


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## Handsome Robb (Jul 29, 2012)

Look at it this way. Either the :censored::censored::censored::censored::censored::censored::censored: dies and gets off easy or from your care along with care at the hospital they survive and spend a hefty chunk of their life in a 6x9 foot cell...
which would you prefer to do? Just one angle to look at it from. 

 Like everyone said, you need to separate yourself from who/what the person is/stands for and do your job.


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## DesertMedic66 (Jul 29, 2012)

NVRob said:


> Look at it this way. Either the :censored::censored::censored::censored::censored::censored::censored: dies and gets off easy or from your care along with care at the hospital they survive and spend a hefty chunk of their life in a 6x9 foot cell...
> which would you prefer to do? Just one angle to look at it from.
> 
> Like everyone said, you need to separate yourself from who/what the person is/stands for and do your job.



Well the first one is cheaper for the state...


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## Handsome Robb (Jul 29, 2012)

firefite said:


> Well the first one is cheaper for the state...



Very, very fair point. Touche' salesmen


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## LondonMedic (Jul 29, 2012)

Striving said:


> (my bro _unfortunately_ shared a surgical recovery room with him)


Why unfortunately?


And anyway, what do you mean by criminal? A convicted felon? Misdemeanant? Suspect? Evildoer? Any patient escorted by someone with a gun and a badge?

This thread stinks of bull:censored::censored::censored::censored:, supposition and prejudice.


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## bahnrokt (Jul 29, 2012)

I don't know how many injured really bad people your goin to see like this.

The tougher patient is the taxi passenger "ohh I have chest pain". You know its BS and you have taken this guy in 5 times over the last month and you know his house, hx, meds, etc by heart.  But you need to step up and provide the same care to him as the "legit" patient because some day he will actually die.  

Personally, I view them as training exercises.


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## Handsome Robb (Jul 29, 2012)

bahnrokt said:


> I don't know how many injured really bad people your goin to see like this.
> 
> The tougher patient is the taxi passenger "ohh I have chest pain". You know its BS and you have taken this guy in 5 times over the last month and you know his house, hx, meds, etc by heart.  But you need to step up and provide the same care to him as the "legit" patient because some day he will actually die.
> 
> Personally, I view them as training exercises.



In bigger urban areas you end up seeing them semi-frequently. 

I agree about frequent flyers though. It's tough to not disregard everything they say.


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## mycrofft (Jul 29, 2012)

Did jail medical for 22 years, street EMT for three (Friday and Sat nights in a Nebraska campus/capitol town).

1. Today's inmate is tomorrow's free citizen and vice versa.
2. You treat everyone to the best you can, but when the patient is in custody you do not reveal/share/give things or turn your back on them.
A long-quoted statistic was that 86% of prison escapes were related to medical services, either during an off-campus medical appt, using materials stolen from Medical section, or with the assistance of (hopefully unwitting) medical personnel.
3. NYMedic 828's point is supported by my experience. Most shooting and virtually all car jacking victims were up to something or willfully (for what reason) driving somewhere they shouldn't.


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## Striving (Jul 30, 2012)

It was just a question, I don't see what is prejudice about it. The only reason I put "unfortunately" was because of that man being in my bro's room it was put on lock down, we were unable to sit with him until he was transferred to ICU.
I'm sorry you think this thread is bull London guy, and that my question is hilarious, things must be different in the UK because here EMS has to ask pt for events leading up to injury when taking the SAMPLE. So it seems odd that you have no idea how any of your pt's ended up in need of your medical care.

I agree these types of calls will be few and far between, and leaving emotions out of the job is essential. My FF buddies have told me the majority of people (in their experience) that get caught committing a crime fake unconsciousness and/or claim chest pain in an attempt to avoid jail for as long as possible (which really isn't long at all).

I only asked this question out of random curiosity, I meant no offense. Thank you guys for taking the time to share your experiences and opinions with little ol' me.


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## MMiz (Jul 30, 2012)

I've treated drunk drivers that killed bystanders in car accidents, robbers, shoplifters, and more.  Everyone gets receives the same standard of care.

I found that once I put on my uniform and started work that I set aside my personal emotions.  I was doing a job, and treated everyone with the same quality of care.

It was usually after a shift or big call that the magnitude of the incidents really hit me.

Part of being a professional is maintaining professional standards.


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## LondonMedic (Jul 30, 2012)

Striving said:


> here EMS has to ask pt for events leading up to injury when taking the SAMPLE. So it seems odd that you have no idea how any of your pt's ended up in need of your medical care.


Of course I do, I just don't care. It makes no difference to the treatment whether someone has wounds from a police baton or a Yardie's baseball bat.


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## Veneficus (Jul 30, 2012)

NYMedic828 said:


> 9.9/10 times if I have a shooting victim at work, it didn't occur because they were an upstanding citizen in the wrong place at the wrong time.
> 
> My job is not to care about the situation its to treat the patient. (as long as it is safe for me to do so)



You mean they were not just minding their own business taking their library books bacK? 

(If it is one thing the 2 dudes cannot stand it is somebody minding their own business.)


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## leoemt (Jul 30, 2012)

As a former police officer I have transported lots of suspects to the hospital either in my patrol car or escorting an ambulance. I don't have a problem and neither should you. Remember, EVERYONE is innocent until proven guilty. It is your job to treat their injury to the best of your ability. It is not your job to judge someone who is in your ambulance. 

As a prior poster said, todays criminal is tomorrows free citizen.


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## mycrofft (Aug 8, 2012)

And vice versa, so watch the driving and texting!


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## SDog (Sep 22, 2012)

mycrofft said:


> And vice versa, so watch the driving and texting!



HAHAHA this public announcement brought to you by....


Good way to throw in some good advice.


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## Shishkabob (Sep 22, 2012)

I won't be your best friend, but you'll still get competent and equal care.


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## Melclin (Oct 1, 2012)

I'll be honest. For the average non-critical job, you won't get my best work. It won't be intentional. But in all likelihood there will be various subtle changes in the way I treat pts I don't like. Its not a value judgement and its nothing really to do with crime. I've treated plenty of criminals I liked and plenty of law abiding citizens, I didn't. Its about whether or not the pt is threatening, rude or doing anything else that pisses me off. If that is the case, while I may consciously try to provide the same level of care, I find I often get to the end of those cases and realise I did a poorer job over all than I would have done had I liked the pt. Its something I constantly try to remedy, but its a basic fact I've observed of my own and everybody else's practice. 

If someone is proper sick though, they'll get my best. Nothing to do with ethics, its just that I don't work in EMS out of some airy notion of wanting to help people. Because I am not motivated purely by a desire to 'help', its irrelevant to my decision making if my pt is a person apparently unworthy of that help.

I like the medically flavoured problem solving. I enjoy applying A&P and pathophys in high stress situations. I like the process of diagnosis, treatment and the feeling of having done a good days work. I take pride in being good at what I do and I want to be better. The pt's hx of being a miscellaneous scum bag doesn't factor into my decision making because the persons character has nothing to do with why I'm treating them. I'm not trying to help them specifically. I'm trying to, overall, provide excellent pre-hospital care and while that often necessitates helping and advocating for your patient (and I do enjoy doing nice things for people), it is not the main reason I front up every day.


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## BassoonEMT (Oct 3, 2012)

As the great Hawkeye Pierce once said "We all bleed the same color."... or something like that.

I've had quite a few calls on my college campus (I'm currently the Chief of my collegiate EMS squad), where I would have to go in to the "interview room" to treat some cuts and injuries that occurred during the process of arresting the subject.  Nothing life-threatening, but it's still a strange situation both in treating a subject in custody, and in the aspect that someone so hostile could potentially attack you.  

Like the old adage states, put on your game face.


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## mycrofft (Oct 4, 2012)

I never wanted to know my patients' alleged crimes so I could never be accused of rendering lesser care.


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