Assault & retaliation/defending yourself

[phideux]

I've been hit once, and almost hit once. the time I got hit was from an unconscious girl, suddenly coming to and thinking she was being kidnapped, let me tell you, sometimes those little 4'11", 95lb "little" girls can pack one hell of a punch. Due to the situation, all was forgiven against her, and she turned out to be a good patient after that.
The almost hit one was a drunk guy that wouldn't get out of my way after the third time of asking him, he was standing there trying to look cool, stylin with his cell. When I finally put my finger on his chest and told him to get the "f" out the way, he reared back to swing, but the idiot never saw the 2 cops on either side of him while this whole thing was transpiring, didn't end good for him.

 

[MediMike]

These kind of threads pop up on a semi-regular basis and I am still astounded by many of the replies. If a patient get's combative then just get the hell out of there. Use enough force to break contact, then run. Unless there are some seriously different protocols in other regions than in the variety of services I worked in for the last decade, it's not your job to take them down.

Get out of the area, and call for law enforcement.

Do you really want to be "that" guy/girl who gets on the news for beating the piss out of a hypoglycemic or postictal fellow?

 

[Bullets]

These kind of threads pop up on a semi-regular basis and I am still astounded by many of the replies. If a patient get's combative then just get the hell out of there. Use enough force to break contact, then run. Unless there are some seriously different protocols in other regions than in the variety of services I worked in for the last decade, it's not your job to take them down.

Get out of the area, and call for law enforcement.

Do you really want to be "that" guy/girl who gets on the news for beating the piss out of a hypoglycemic or postictal fellow?

Sometimes there is no avenue of escape, as much as i am one to take note of all exits when i enter a scene. I dont think anyone here is advocating savagely beating someone unless it is warranted to ensure you can get out alive.

That said, choke holds and arm bars work best

 

[MediMike]

It's your job to ensure those avenues exist. And again, if they don't immediately due to poor planning or simple logistics, enough force to break contact and get out.

Do you really think it's appropriate to apply a choke hold or arm bar to a patient, or to advocate for that kind of response? If so, I wish you, your career, and the patients you run into the best of luck, because all of you are going to need it.

(I'm sure this is going to end up as an "agree to disagree" thread so I'll probably check out now haha)

 

[NomadicMedic]

Combative vs swinging at me. Two very different things. Combative is somebody not in command of their faculties who gets versed/haldol. Swinging at me gets the Calvary coming to rain down hellfire upon them. Then it's versed/haldol unless they're in cuffs. I'll never wallop a patient with a flashlight or go hands on unless I, or my partner, is in imminent danger.

Also, if anyone every touches you, it's important to fully prosecute. Don't brush it off.

A Skip Kirkwood post:

"On June 30, 2013 the Governor signed Senate Bill #12 which adds "paramedic" to the list of professions that augment offensive touching to a Class A misdemeanor in Delaware. While it could be argued that paramedics were already covered as "medical professional" or "emergency medical technician", it is now clear that offensively touching a paramedic during the performance of their duties is the same as if it were done to a police officer or firefighter. Thanks to the General Assembly and Governor for helping protect paramedics in Delaware."

 

[Tigger]

I've been hit once, and almost hit once. the time I got hit was from an unconscious girl, suddenly coming to and thinking she was being kidnapped, let me tell you, sometimes those little 4'11", 95lb "little" girls can pack one hell of a punch. Due to the situation, all was forgiven against her, and she turned out to be a good patient after that.
The almost hit one was a drunk guy that wouldn't get out of my way after the third time of asking him, he was standing there trying to look cool, stylin with his cell. When I finally put my finger on his chest and told him to get the "f" out the way, he reared back to swing, but the idiot never saw the 2 cops on either side of him while this whole thing was transpiring, didn't end good for him.

I'm having a hard time picturing a scene where it would be necessary to curse at a bystander or anything like that, especially with law enforcement on scene.

Not saying it's ok for a drunk person to ever attempt to hit a provider, but there is also something to be said for avoiding confrontation.

 

[mycrofft]

These kind of threads pop up on a semi-regular basis and I am still astounded by many of the replies. If a patient get's combative then just get the hell out of there. Use enough force to break contact, then run. Unless there are some seriously different protocols in other regions than in the variety of services I worked in for the last decade, it's not your job to take them down.

Get out of the area, and call for law enforcement.

Do you really want to be "that" guy/girl who gets on the news for beating the piss out of a hypoglycemic or postictal fellow?

Or the drunk or whoever beats YOU to death?

 

[Glucatron]

It always depends on the situation. If I get on scene and the person comes swinging at me we usually have enough people to safely restrain and transport the person. If not then it depends. If we both feel uncomfortable trying to restrain the person alone call for police and/or fire back up and stay away from pt (just monitor their movements). For my partner and I if the person is smaller and we communicate we are both willing to restrain them we will. But typically we just try to have numbers on our side. It also helps if it ever goes to court to have pd and fire with you. Body language is a big deal. If you are about to transport and you feel uncomfortable like they may try to attack or flee I recommend setting ground rules and showing that you are not someone they can control or mess with. And you do this solely through words and body language. I'll say, " I understand you are angry and feel we have no right to take you but we believe you are a threat to (yourself, others etc). No one here wants to hurt you, hell, we're trying to help ya. But you can either come with us voluntarily to the ambulance. We will put on some seatbelts, start an IV, take a blood pressure, etc.. Or you can refuse and we will have to make you come with us." if they agree voluntarily but seem shady I'll add, " I have two rules: seatbelts stay on, you keep your hands to yourself. You violate either you will be restrained." usually when they understand that you are serious they will not push it any further. If they continue to get more and more argumentative we will explain one more time. Knowing your ultimatum can be backed up with action is usually enough. Ofcourse if after this they continue to resist (note: it is very important you make sure you are justified in taking them against their will, kidnapping is a serious offense) one person per limb yadee ya. If they are truly aggressive police may need to taze or take the person down their way. Take either a fire rider or police officer when transporting if they do comply but you suspect they may become combative anyway.

If during a transport the pt becomes combative and I am alone I will shout "dog in the road" and then hold onto something, my partner is going to stopping the ambulance fast. If the pt is coming at me I will defend however is most effective while trying to avoid hurting them. However, I'm on the lower end of 5' so if they are much larger I'll probably be much more aggressive about preventing attacks. If they are actively attacking I will pretty much assume communication is pointless because well, their fist is about to meet my face.

 

[Rialaigh]

Or the drunk or whoever beats YOU to death?

When was the last time you heard of a drunk person beating an EMT to death....



Now when was the last time you heard of law enforcement or EMS restraining a patient that ultimately died....



This job carries risks, you knew that when you trained, you knew that when you worked, you know that when you take a new position within EMS. I dislike the people that think we shouldn't have to or be required to take risks. It is part of the job, It SHOULD be part of the job, the pay and demand for EMT's and Medics reflects that potential employees are willing to take these risks.

 

[Kevinf]

The training to do so with some modicum of safety/competence is not part of the curriculum nor is it rehearsed regularly to stay current. When dealing with combative subjects police use overwhelming force of personnel and they have several tools to restrain, incapacitate, or outright kill someone if need be. We don't get sent out with ballistic vests, pepper spray, tasers, batons, dogs, or firearms and the training to use them.

It's a different skill set entirely and getting into it with someone without the proper training is trouble with a capital T. Even LE runs into situations they can't handle and people end up dying. We don't put out fires and we don't arrest people, which is what restraining a combative patient is.

 

[epipusher]

The training to do so with some modicum of safety/competence is not part of the curriculum nor is it rehearsed regularly to stay current. When dealing with combative subjects police use overwhelming force of personnel and they have several tools to restrain, incapacitate, or outright kill someone if need be. We don't get sent out with ballistic vests, pepper spray, tasers, batons, or firearms and the training to use them.

It's a different skill set entirely and getting into it with someone without the proper training is trouble with a capital T. Even LE runs into situations they can't handle and people end up dying. We don't put out fires and we don't arrest people, which is what restraining a combative patient is.

Well said.