ECW/Taser Patient Management

EpiEMS said:
Absolutely fair - it's just those folks who aren't asymptomatic, awake, and alert who may benefit from further assessment (e.g. a 12-lead). Heck, I might even get an ALS assessment if it's a "prolonged" use of a taser (though this would probably be covered by the other qualifications I stated).



Is this for all tased patients, or just those who need something removed?
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All depends on the officer and department. We have some where if they got tased we evaluate them every time and others where we don't respond at all.
 
My department says we're allowed to remove probes. We're even instructed on how to do it at our academy during our initial Taser training. Even with being able to remove the probes we still have to take the person to a local hospital and burden them with an ok to book.

The trip to the hospital is usually done in a patrol car. I've only had one person who had a Taser used on them go by ambulance. He had been involved in a pursuit, crashed, and ran from the crash. He had some righteous non Taser related injuries from the crash and ended up being intubated at the hospital.
 
EpiEMS said:
Any idea what the hospital work-up is?
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Last time I had to sit on one it was real simple stuff. Tech came by for a 12 lead and some bandaids got put on the small puncture wounds. I don't remember any blood work being done.

Occasionally if we aren't able to get the probes out in the field they'll pull them at the hospital and on the rare case the probe gets imbedded they'll do an X-ray to locate it and pull it out after. Most of the time is spent waiting on the paperwork to take with me to the jail to say the person has been checked over.
 
chrls said:
Last time I had to sit on one it was real simple stuff. Tech came by for a 12 lead and some bandaids got put on the small puncture wounds. I don't remember any blood work being done.

Occasionally if we aren't able to get the probes out in the field they'll pull them at the hospital and on the rare case the probe gets imbedded they'll do an X-ray to locate it and pull it out after. Most of the time is spent waiting on the paperwork to take with me to the jail to say the person has been checked over.
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You should fly in the next taser patient for an ok to book.
 
again, back to what @NomadicMedic said a while ago. Let people do their jobs. Cops do the arresting/tasing/safety, medics do the evaluating and treatment/medicine, firefighters do the firefighting... How is a LEO going to know if theres something wrong? Just the same way as would an EMT know how to use a taser safely and effectively, say the right things ect? Would a firefighter know medicine(joking!) lol ;).
 
NysEms2117 said:
Let people do their jobs. Cops do the arresting/tasing/safety, medics do the evaluating and treatment/medicine, firefighters do the firefighting... How is a LEO going to know if theres something wrong?
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Boy, if only...I'm not expecting they (LE) should be experts in EMS, or our protocols, just as you said we don't know too much about theirs.

That said, there's a little thing called common sense, coupled with his cousin good judgment. A lot of the times it seems like, or comes across as, a pawn off or a reason to do less paperwork.

The point I'm trying to make, NYS is after a while you start seeing how they too write these people off as: "well, that's what the ambulance is for.", just like I've seen some ALS fire departments do. The "ambulance" truly is the safety net used to catch what others throw back into the sea of less desirables.

So I ask, do you honestly think some LEO's don't see it this way, and/ or won't abuse the ambulance as much as some of our super users? Heck, oftentimes the two are caught in tandem.

How is it in this day and age other departments may not give EMS its "public service" title, yet we seem to serve the public most other choose not to? It sure must be nice to have a choice.
 
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VentMonkey said:
Boy, if only...I'm not expecting they (LE) should be experts in EMS, or our protocols, just as you said we don't know too much about theirs.

That said, there's a little thing called common sense, coupled with his cousin good judgment. A lot of the times it seems like, or comes across as, a pawn off or a reason to do less paperwork.

The point I'm trying to make, NYS is after a while you start seeing how they too write these people off as: "well, that's what the ambulance is for.", just like I've seen some ALS fire departments do. The "ambulance" truly is the safety net used to catch what others throw back into the sea of less desirables.

So I ask, do you honestly think some LEO's don't see it this way, and/ or won't abuse the ambulance as much as some of our super users? Heck, oftentimes the two are caught in tandem.

How is it in this day and age other departments may not give EMS its "public service" title, yet we seem to serve the public most other choose not to? It sure must be nice to have a choice.
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My point remains.... EMS does the medical. Do LEO's see ambulances as that... yes, but they should if they have to use force of some kind IMO. How do i know when i tackled my parolee into a wall or a table he didn't break a rib. They all say they have pain, they may have a bruise because they got tackled, but they may also have a fractured rib going to a Pneumo? It's not less paperwork, hell it may even be more, but i know for a FACT the one time i don't offer, or i don't call, something bad will happen and i will lose my job, so for my families(all-be-it a small one) sake (as well as my own) Im not taking that risk.

Couldn't the same thing be said about scene safety? When your in doubt do you not call LE? You don't want to take a risk of being hit by a car, or a person popping out of the dark scary alley with a gun/knife/bat/*list painful object here*. I've seen it typed before on here along the lines of i'll let the person with the gun deal with that(because thats our job).

My end piece is theres a lot we can't see with the human body, if i use force of any kind (short of saying sir please turn around), something may happen to that suspect that wasn't there before.. Whether it be a bruise, GI bleed, or a Pneumo. Do you hate being called for that stuff, sure. Just think about the other side though, especially now when any cop, parole officer, correctional officer, or any law enforcement official/agent has a huge target on their back. Is it worth the risk of losing your job or calling a non emergent ambulance to come?
**not trying to start a war or poke a bear. Just stating how i see it from the LE side**
 
At my old service they called for all removal. It was basically a grip and rip process. We always offered transport but they almost always refused or PD denied them them the opportunity. It was actually a little annoying because taser barb removal was considered an ALS skill.

Where im at now PD removes them their selves. They hardly ever call us to transport pysch holds (which the PD in the EOA of my other service always did).

We rarely ever did anything other than basic vitals and control bleeding. I dont know what ALS assessment means to others (to me it simply means a Medic doing an assessment) but a BGL is the most a known refusal gets in this area.

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Ah, good point - technically, yes, an ALS assessment is just that a medic (or, in some places, an AEMT/EMT-I) does the assessment. I was thinking more like EKG, because as far as an assessment goes, that's all they can do that I cannot (admittedly, they know/are trained more than I, but it's not like A&P or physical exam techniques are limited by your cert level)

Certainly sounds like, in general, dealing with tased patients is something pretty low-risk, at least, medically for the patient.


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NysEms2117 said:
My point remains.... EMS does the medical. Do LEO's see ambulances as that... yes, but they should if they have to use force of some kind IMO. How do i know when i tackled my parolee into a wall or a table he didn't break a rib. They all say they have pain, they may have a bruise because they got tackled, but they may also have a fractured rib going to a Pneumo? It's not less paperwork, hell it may even be more, but i know for a FACT the one time i don't offer, or i don't call, something bad will happen and i will lose my job, so for my families(all-be-it a small one) sake (as well as my own) Im not taking that risk.
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fair enough... so if you tackle your parolee, do you automatically call an ambulance and have him transported (against his will, because i'm guessing he is now in your custody) and have him evaluated by the MD, just to cover your butt?
NysEms2117 said:
Couldn't the same thing be said about scene safety? When your in doubt do you not call LE? You don't want to take a risk of being hit by a car, or a person popping out of the dark scary alley with a gun/knife/bat/*list painful object here*. I've seen it typed before on here along the lines of i'll let the person with the gun deal with that(because thats our job).
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I can count on one hand how many times PD beat EMS and FD to an MVA at my old job.... more often than not, we would have to rerequest PD to respond after we had already been on scene for 20 minutes..... If I had a dollar for ever call that I staged on just because someone might be hiding in the dark alley, i'd have maybe two dollars..... That being said, if I KNOW they are armed with a knife, I'll gladly wait for PD to disarm the individual, but I don't let my fear of the boogyman prevent me from doing my job
NysEms2117 said:
My end piece is theres a lot we can't see with the human body, if i use force of any kind (short of saying sir please turn around), something may happen to that suspect that wasn't there before.. Whether it be a bruise, GI bleed, or a Pneumo. Do you hate being called for that stuff, sure. Just think about the other side though, especially now when any cop, parole officer, correctional officer, or any law enforcement official/agent has a huge target on their back. Is it worth the risk of losing your job or calling a non emergent ambulance to come?
**not trying to start a war or poke a bear. Just stating how i see it from the LE side**
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so the next medical call I get, I am going to stage until PD gets there.... just in case.... so when grandma is having chest pains, I'm going to wait for PD to arrive first, because there might be "a person popping out of the dark scary alley with a gun/knife/bat/*list painful object here*"

I can completely understand the LEO point of view. They don't want to assume the liability for any possible injuries, so EMS is called to take the person to the hospital just to "check them out." But it's as overkill as me requesting an officer to transport with us in the ambulance with a 70 year old lady, who "might get violent and need to be restrained." And it's not like I can really do anything.... I can take them to the hospital or they can refuse to be transported. And here is the big secret: even if they do refuse, if you did damage them, and they sue you, you can still be found liable for injuries that you caused during the execution of your duties. All you are doing is dragging me into the suit with you.
 
EpiEMS said:
Certainly sounds like, in general, dealing with tased patients is something pretty low-risk, at least, medically for the patient.
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i can agree to this. As stated above our/my (LE) only concern is that 1-2%. Especially in 2017 where you'll catch a lawsuit for breathing improperly.
 
here are my county's taser probe removal procedures:

Clinical Indications:
Patient with uncomplicated conducted electrical weapon (Taser®) probes embedded subcutaneously in non-sensitive areas of skin.
Taser probes are barbed metal projectiles that may embed themselves up to 13 mm into the skin.
Contraindications:
Patients with conducted electrical weapon (Taser®) probe penetration in vulnerable areas of body as mentioned below should be transported for further evaluation and probe removal
- Probes embedded in skin above level of clavicles, female breasts, or genitalia
Suspicion that probe might be embedded in bone, blood vessel, or other sensitive structure.
Procedure:
Ensure wires are disconnected from weapon.
Stabilize skin around probe using non-dominant hand.
Grasp probe by metal body with pliers or hemostats to prevent puncture wounds to EMS personnel.
Remove probe in single quick motion.
Wipe wound with antiseptic wipe and apply dressing.
Certification Requirements:
This procedure is limited to Tactical Medics only

and North Carolina does have a protocol for how to handle people in police custody (just google it if you want to pull up the flow chart)
 
DrParasite said:
fair enough... so if you tackle your parolee, do you automatically call an ambulance and have him transported (against his will, because i'm guessing he is now in your custody) and have him evaluated by the MD, just to cover your butt?
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well if you'd like to get down to the nitty gritty, my parolee is Property of NYS. If your on parole you are a term called "civically dead" meaning your rights were taken away when you committed whatever felony landed you in state prison(I only deal with convicted felons). All of that mumbo jumbo means, I as their parole officer now decide yes or no for them. If i tackle them chances are I did some kind of damage somewhere (im 5'11-6' 200(ish)) + my vest and gear(adds about 40-50 lbs).
DrParasite said:
If I had a dollar for ever call that I staged on just because someone might be hiding in the dark alley, i'd have maybe two dollars..... That being said, if I KNOW they are armed with a knife, I'll gladly wait for PD to disarm the individual, but I don't let my fear of the boogyman prevent me from doing my job
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We didn't let boogyman prevent us from doing our job either, we(LE) tased subdued and controlled the individual. I was also stating that from a basic EMS standpoint, you experienced folks have common sense, and can use that in a practical setting, most people i've met in EMS cannot, and i was stating my statement above at them.
DrParasite said:
so the next medical call I get, I am going to stage until PD gets there.... just in case.... so when grandma is having chest pains, I'm going to wait for PD to arrive first, because there might be "a person popping out of the dark scary alley with a gun/knife/bat/*list painful object here*"
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never said it's correct, but when new EMT-B's get taught what is the first thing they are taught and have to say every 30 seconds or so throughout EMT class?? for me it was: "BSI Scene safety"
DrParasite said:
I can completely understand the LEO point of view. They don't want to assume the liability for any possible injuries, so EMS is called to take the person to the hospital just to "check them out."
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A majority of them don't end in transports on the parole side, because as i said before do i call for a medic? sure do, do they come flashing lights running red lights reaper racing? nope. When they come they do their assessment, say looks fine to me Andrew, what do you want us to do? Have a good day medicman bob.

Your also completely right I could be sued, but I'm not going out looking to tackle people. I sure as hell won't tackle granny. If I end up using physical combat instead of something on my bat belt, generally speaking something went wrong. Again I refer to the whole civically dead thing. + all this time im doing running and preparing to tase i'm identifying myself telling them to stop and put their hands up, if they refuse they break S 205.30 (penal law of NYS)
 
@DrParasite how is the general working relationship between the agencies in your area?

I think generally speaking ours is decent, and it only makes me smile when I see a former employee of ours who's now a LEO. I'm not trying to turn this into a "battle of the badges" debate, that's just played out, but I think what Nomad meant, NYS was yes, we each have designated roles, but that doesn't mean that there's more than one way to look out for one another.

With due respect, once you've done this long enough without any LE background you can't see things quite like a cross-trained person such as yourself. They do bully "patients" on EMS every single day.

I'm not talking about tasered patients, I'm talking about the handful where I ask and get an "nah, I'm not doing anything here, we're good." that began as maybe a domestic dispute, that then turned into a medical aid. I don't know the differences between parole, and corrections, and patrol to cite anything specifically, so I won't; I just know what I've seen in my career. Ask the many vets on here as I am sure they've seen/ been privie to the same; it's nothing new. I get some of it, but like I stated earlier, don't worry about all of it.

FWIW, I haven't had too many CHP tasered patients let alone pawn offs by this particular department, even when backfilling or covering for other LE agencies.
 
VentMonkey said:
@DrParasite how is the general working relationship between the agencies in your area?

I think generally speaking ours is decent, and it only makes me smile when I see a former employee of ours who's now a LEO. I'm not trying to turn this into a "battle of the badges" debate, that's just played out, but I think what Nomad meant, NYS was yes, we each have designated roles, but that doesn't mean that there's more than one way to look out for one another.
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When I was in NJ, we had a pretty decent relationship with PD.... but they were even more understaffed than we were.

In fact, the only agency I had any real issues with was one of the college police departments, whose personnel tending to make situations worse than before they got there, and really needed to take it down a notch.... Fortunately I knew their Sgt, and she was usually able to get them to calm down.

I also did have an "issue" with one of the sheriff's deputy's in the county courthouse.... the patient wanted to go to the hospital, the officer didn't want him to go.... I (respectfully) said it's probably BS, but because of the patient's history, they really should go..... do you want to take responsibility if he dies? I will need your name and badge number please..... After a few phone calls that went up to the duty captain (or higher I don't remember), we took him, and me and the Sgt had a great relationship since.
VentMonkey said:
With due respect, once you've done this long enough without any LE background you can't see things quite like a cross-trained person such as yourself. They do bully "patients" on EMS every single day.
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I agree with you 100%. and while LE can dump a person on EMS (pick one, jail or the ambulance), 99.999% of the time they will be in the ambulance before you are, and most agencies can't deny a person a ride to the hospital.

But I've also been doing this long enough to realize that stopping that isn't handled at the street level, it's handled by strong leadership in EMS and having good relationships between the heads of your agencies.
 
DrParasite said:
But I've also been doing this long enough to realize that stopping that isn't handled at the street level, it's handled by strong leadership in EMS and having good relationships between the heads of your agencies.
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This couldn't be closer to the truth, and just circles back to the point I was trying to make a few posts up.

I get that they have their job to do, we have ours, yada yada yada, but there really does need to be a mutual respect between the agencies; as a whole I wonder if there really is. I'm not referring to a cop here, another there, a medic here, or one over there.

Since we seem to continue to be that "red headed stepchild" I sadly don't think that this is the case nationally. Again, it's not an us vs. them thing to me more so as it is an us fitting into the public service model respectively; nothing new there either.
 
VentMonkey said:
With due respect, once you've done this long enough without any LE background you can't see things quite like a cross-trained person such as yourself. They do bully "patients" on EMS every single day.
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Understood, I'm trying to get to that point(in real life as well as on here), I fully agree that LE does force the hand in certain cases. the only reason that i specifically designated that im parole is the simple fact of when i work as a parole officer i know who im dealing with. I know for a 100% fact it is mike smith who went to Elmira state prison for aggrivated assault with a deadly weapon, who's 32 years old, and has a unicorn tattoo on his left hand. Patrol officers/agents go from dealing with little suzie, to gang member, to granny who rear ended somebody. They don't know who they are dealing with (This plays a key part in the topic at hand, because i would know that parolee 73 on my caseload has a heart condition and i would deliberately take a taser off my batbelt so i didn't kill him if he ran.)
I also agree with both you and Dr. P that having good relations may eliminate some BS on both ends. which I think both sides would enjoy.
**as mentioned in a thread i started please feel free to PM me if you have any ideas for "mending LE and EMS" relations, I can take them to my boss and potentially start something up**
 
NysEms2117 said:
. Patrol officers/agents go from dealing with little suzie, to gang member, to granny who rear ended somebody. They don't know who they are dealing with
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Yeah, this could be awfully risky on the medical side. That said, we need to think clinically - most tased folks don't have any issues. Those that do (i.e. aren't alert/oriented/ambulatory after) could benefit from an evaluation.
 
EpiEMS said:
Yeah, this could be awfully risky on the medical side. That said, we need to think clinically - most tased folks don't have any issues. Those that do (i.e. aren't alert/oriented/ambulatory after) could benefit from an evaluation.
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I say this as I'm waiting in an airport 3 hrs late for an hour long flight... How can you expect a leo to do both medicine and law/safety? Leo's don't expect you to chase after the murderers. Or jump into a fire. If they aren't conscience/oriented shouldn't they be under medical care?
Again I'm not disagreeing that there not an issue at hand. I'm just asking as an Leo providing for your family, would you take that chance? Where you know damn well If something goes kaflewie your on the chopping block. Even if a medic clears them after a simple evaluation at least there's a second set of eyes saying "he looked like this" and any extra confirmation helps in court.


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