CCP in a 911 Setting

[CCCSD]

Not sure I understand. Pretty easy to fill out the paperwork and give meds. Not sure what you mean by controlling the scene, peacocking around with behavioral crisis patients doesn't really seem to work in my experience.

I would say you don’t have much experience with 5150s then. I’m not sure what you mean by “peacocking”, however, if that was a dig, it failed.

 

[RocketMedic]

If it meant more dealing with psych patients, I would not seek CCP at all. I mean, in my opinion, these people really don't need EMS services; they need psychiatric services and care that EMS does not and will not be able to provide, and our sole value to them is transportation. Transportation that will not be reimbursed.

I'd love to see law enforcement taking a lot more psych care responsibilities.

 

[DrParasite]

99% of the psych patients will not be helped by EMS. they need transport to a psych facility for long term care (either in patient or outpatient). ambulance, cop car cage, taxi, whatever, it doesn't really matter. if they are violent, sedate them (which doesn't solve the issue, but it makes them easier to deal with), or just restrain them with silver bracelets and take them against their will (which helps short term, but doesn't solve the issue at hand).

The biggest role EMS plays in psych emergencies is in ruling out other reasons why the person is acting acutely crazy. But once that's done, it's all a taxi service.

 

[Tigger]

I would say you don’t have much experience with 5150s then. I’m not sure what you mean by “peacocking”, however, if that was a dig, it failed.

It's not a dig. It's more that the whole basis of EMS always being in charge of the patient and their needs (a common attitude no doubt) is probably not the way we should be handling behavioral patients aside from the ones that are about to seriously hurt us, and then you should probably just leave.

I mean sure, I don't have tremendous experience working with behavioral patients, it isn't like we are one of very few services anywhere that has paramedics directly placing these patients in inpatient beds. Or that we provide pysch services to the local critical access hospital. Or that all of our paramedics go through a six month long, community college program learning how to better serve these patients/clients where actual soft skills are taught to kind of take the edge off of the average EMS's providers encounter with these patients. If I've learned one thing from all of this, it's that walking in with the "easy way or the hard way" strategy is no way to treat anyone with respect during a crisis and that as an organization we have been much more effective meeting these clients at their own level of needs and letting them participate in the course of their own care.

But hey, not much experience here and of course your mileage may vary.

 

[Tigger]

If it meant more dealing with psych patients, I would not seek CCP at all. I mean, in my opinion, these people really don't need EMS services; they need psychiatric services and care that EMS does not and will not be able to provide, and our sole value to them is transportation. Transportation that will not be reimbursed.

I'd love to see law enforcement taking a lot more psych care responsibilities.

Why does it fall to law enforcement? They aren't exactly healthcare providers, and having a behavioral crisis is hardly illegal activity.

99% of the psych patients will not be helped by EMS. they need transport to a psych facility for long term care (either in patient or outpatient). ambulance, cop car cage, taxi, whatever, it doesn't really matter. if they are violent, sedate them (which doesn't solve the issue, but it makes them easier to deal with), or just restrain them with silver bracelets and take them against their will (which helps short term, but doesn't solve the issue at hand).

The biggest role EMS plays in psych emergencies is in ruling out other reasons why the person is acting acutely crazy. But once that's done, it's all a taxi service.

A taxi ride to the correct destination, which is not the Emergency Department. These patients tie up beds and cost a fortune, and as you say, need no emergency medical care. So why not rule out the organic causes and take them somewhere appropriate while not using an ambulance, which is rather expensive to operate?

 

[DrParasite]

A taxi ride to the correct destination, which is not the Emergency Department. These patients tie up beds and cost a fortune, and as you say, need no emergency medical care. So why not rule out the organic causes and take them somewhere appropriate while not using an ambulance, which is rather expensive to operate?

correct, which is why I said they should go to a psych hospital and not the ER. The exception to this would be for a legit acute psychotic episode; there people should got to the ER to rule out a medical cause for their crazyness (seen once in my entire career, the rest were all chronic or worsening psych issues). or those under the influence, got to make sure those clear their system before the psych hospital will look at them.

 

[RocketMedic]

I reckon that the vast majority of psych cases, once cleared of obvious organic issues, can safely wear bracelets and take a ride to a crisis center.

 

[rescue1]

I'm pretty sure the vast majority of crisis center-appropriate patients don't require handcuffs