drunkies

dslprod

Forum Crew Member
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hey how do you guys transport a highly intoxicated person? what position are they in? i would assume theyre placed in the lateral position with suction ready to go when they vomit ....?
 

EMTCop86

Forum Captain
339
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It depends. How is their behavior? Are they agitated and fighting with you or are they being clam and just laying there?
 

PapaBear434

Forum Asst. Chief
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Usually the same as any other patient. If they are unconscious, they may or may not be boarded, but they will be laying down. Conscious, they are sitting up per usual.

If the situation changes, then you change with it.
 

nomofica

Forum Asst. Chief
685
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calm/passed out = recovery position
ready for some finger sweeping action.
 

Sapphyre

Forum Asst. Chief
914
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It depends on how alert they are. Not alert/barely alert and not boarded, left lateral, and no, I'm not holding onto the suction just WAITING for them to vomit. I get it if they do. However, most of my drunks are still pretty alert, I let them assume a position of comfort (so long as they're strapped into the gurney)
 

Hockey

Quackers
1,222
6
38
Laying on there stomach


Why?

Because every drunk I have picked up are in handcuffs, extremely uncooperative, and just honestly, trying to kill myself or the officer.

Tasers work nice with a shot in the leg once they break the seatbelt free and start kicking ;)

I love drunks.
 

boingo

Forum Asst. Chief
518
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Laying on their stomach is a BAD idea. When you have your first positional asphyxia arrest you'll change your mind. Having been there, done that, I assure you, it sucks. Don't transport restrained patients prone.
 

Hockey

Quackers
1,222
6
38
Laying on their stomach is a BAD idea. When you have your first positional asphyxia arrest you'll change your mind. Having been there, done that, I assure you, it sucks. Don't transport restrained patients prone.

Well I should say they aren't COMPLETELY prone, but a little to the side. But they aren't in the "normal" position
 

aandjmayne

Forum Crew Member
74
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left lateral recumbent position in case they vomit.. suction on standby... never prone.. its usually more comfortable for them in the fetal position anyway..
 

Buzz

Forum Captain
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The majority of drunk patients I've transported have been immediately following head injury and loss of consciousness or other significant MOI, so they get back boarded. The other ones, I'll let them sit any way they want, within reason, which is usually sitting straight up. Never once had anyone throw up in the truck.
 

mycrofft

Still crazy but elsewhere
11,322
48
48
Who said "sweeping action"?

Only if I have a Dust Buster. I'd as soon put my finger into a person's mouth and between their teeth, especially a drunk, as I'd put my, er, wristwatch there. Blind sweeps are out anyway.
I've seen more airways go to heck when the pt is SUPINE than prone, but it's hard to manage an airway with the airway out of your vision, unless you use the secret ninja posterior approach crycothyrotomy.
Also, yes I like my drunks "clam" as well....clammed up.;)
 

BLSBoy

makes good girls go bad
733
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I let em drive while I take a nap on the cot.
 

BossyCow

Forum Deputy Chief
2,910
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Couple of points....

First, read your protocols regarding restraints. In our system, by our protocols, we are not allowed to transport in handcuffs unless there is no other option and the failed attempts to use other methods needs to be documented in the report.

Second, not all drunks are combative, not all drunks are unconscious, not all drunks are without significant health issues that need to be evaluated/treated.

Being authorititative with a belligerent drunk is more likely to escalate the situation than solve the problem.

We need to treat medical conditions, not situations. If I have an unconscious pt, I'm going to treat them pretty much by the same protocol, regardless of what particular method got them there. My issue is the unconsciousness. Any unconscious pt has the possibility of vomiting. The drunk with a belly full of Jack Daniels isn't much different than the other non drinking patient who just ate a big meal except that the aftermath might smell a bit worse in the first case. (Damn I hate that smell!!!)

Treating a pt with respect for their humanity is a core skill. I can be anyone's best friend for the time it takes to transport them to the ER. I can put aside my personal likes, dislikes, political beliefs, religious preferences, and moral code for the duration of a call. I don't have to agree with the patients life choices in order to treat them with respect. To be honest, direct, polite, and socially acceptable.

Drug or alcohol abuse may turn them into an a*****e but that doesn't mean I have to become one as well. This particular philosophy has been extremely effective in minimizing the confrontations between myself and those under the influence of chemicals. Case in point, the other night, we were toned out to 'man unconscious in highway' Arrived to find unconsious 40 something year old male, passed out 2am, on the highway. Two lane state highway, about 36 degrees out.... Raining...Guy reeked of possible ETOH. No LEO available. We were told that the sheriff's deputy was responding to another call and the troopers (state highway, their jurisdiction) would be enroute "after he got into his car" at a location 48 miles east of us.

The first volunteers on scene were unable to get any information from the guy. He did sit up and talk to them. Told them he was fine and to leave him alone. He was mildly combative, uncooperative, and mildly beligerent.

Guy is refusing treatment. But, if he's really drunk (ie. drunk enough to pass out in the middle of a highway) can he give legal refusal? Those first on scene were demanding his name. They were standing above him, speaking in loud, declarative statements. "We need your name!" "What are you doing here?" "You have to... ", "You must....." and they were getting absolutely no where.

In five minutes I had not only his name, but his DOB, last known address, a short medical history and enough information to determine his fitness to decline treatment. I made him promise to stay far enough off the road to avoid getting hit. To stay safe and in the future, to move further off the highway if he needed to take a nap. He shook my hand, thanked me and went on his way.

The big difference was instead of demanding his name, I put my hand out and introduced myself.. My name is.. and what's yours? Instead of an interrogation, it was a social exchange.

There will be exceptions. But our approach can turn the exception into the rule.
 

daedalus

Forum Deputy Chief
1,784
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First we have the suspect..er..patient tasered, and than sandwiched between two backboards and placed upside down on the gurney, with the heaviest officer sitting on top on the who contraption. Usually, they are unable to respire after this an expire en route, thus eliminating the problem and saving an ER bed.
 

BLSBoy

makes good girls go bad
733
2
16
In five minutes I had not only his name, but his DOB, last known address, a short medical history and enough information to determine his fitness to decline treatment. I made him promise to stay far enough off the road to avoid getting hit. To stay safe and in the future, to move further off the highway if he needed to take a nap. He shook my hand, thanked me and went on his way.

The big difference was instead of demanding his name, I put my hand out and introduced myself.. My name is.. and what's yours? Instead of an interrogation, it was a social exchange.

While I would be the first to put my boot in a butt, and roust an "unconscious" drunk from a park bench, the corner booth at KFC, or under the boardwalk, rather then take them to the hospital if they don't want to go, a highway is not the place to place boot to butt, and take his word that he will stay off the highway.

Do something that is completely out of the ordinary (try to nap on the casino floor), or that completely contradicts something I request ("please sign here, and move on sir", and I end up with a short narriative of his lifes experiences in Vietnam), and you go.
I won't take the chance of them doing something stupid again, and have it come back to bite me in the arse.
 
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Ms.Medic

Forum Captain
251
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The "rock a bye baby" position, you know, place their head on your chest, rub their face, sing to them, thats what I do, it keeps em calm !!! Okay I made that up..... But, any other way to get them just to go to sleep or lay there without bothering you would be nice. :wub:
 

BossyCow

Forum Deputy Chief
2,910
7
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While I would be the first to put my boot in a butt, and roust an "unconscious" drunk from a park bench, the corner booth at KFC, or under the boardwalk, rather then take them to the hospital if they don't want to go, a highway is not the place to place boot to butt, and take his word that he will stay off the highway.

Do something that is completely out of the ordinary (try to nap on the casino floor), or that completely contradicts something I request ("please sign here, and move on sir", and I end up with a short narriative of his lifes experiences in Vietnam), and you go.
I won't take the chance of them doing something stupid again, and have it come back to bite me in the arse.

LOL.. I didn't. Once I was able to get the man to talk to me, I was able to ascertain that he was alert to person, place and time. He was able at that point to make an informed decision to refuse treatment and my opinions on his sobriety no longer mattered. We had no law enforcement available. We turned in all the info we got on the man, the direction in which he was headed and a physical description to dispatch. Once he refused treatment in compliance with all the legal criteria regarding his competency, he was no longer a patient and no longer our concern. Law Enforcement didn't see him as enough of a problem to take less than 15 minutes to make the trip from the break room at the station to the car in the parking lot, so I'm guessing it was a low priority issue for them as well.

Walking along the highway with a snoot full is not my idea of a longevity increasing behavior, but its also not a medical issue. The man was homeless, was heading towards town. and was neither sick nor injured in any way obvious to me.

Since you take issue with the way I handled the situation, what would you have done differently? He was pretty adamant that he did not want transport, evaluation or any attention at all from EMS.
 

mycrofft

Still crazy but elsewhere
11,322
48
48
Jack Daniels? Speak to me not of smelly "Jack Daniels"

Try "Southern Comfort", or "Peppermint Schnapps", or heaven help me, "mead".
Yeah, we get all macho here but sometimes it pays to play it like they all are like us...which by and large, despite our prejudices, they really are.
PS: "Boot to Butt" is called "aggravated assault" if the pt is unconscious and unable to move or defend himself. I have this interesting powerpoint I made for a class about approaching and managing people with altered consciousness and pseudoseizures, it'll go on sale any day now...not.
 
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