ED and Security

[bigbaldguy]

Many of the key pads here have a button that rings to security, perhaps push the button and when they answer let them know there's someone at the door, then run like hell? The other option would be to walk the guy around to the waiting room entrance. Of course if he's a maniacal mad man he will probably kill you as soon as you're out of sight then return to burn your ambulance. Just sayin.

 

[Jon]

Around here, when family comes in with us, they are usually escorted through the ED to the front by a member of the crew (I love having 3rd riders and volunteer help!), or remain at the nurses station or with the patient until one of the crew is free.

For the walkup?
For the most part, I kindly direct the person over to the main entrance. I'm not going to go hands-on to prevent someone from entering though the ambulance bay - NOT my job (anymore).

For the most part, people will obey, either because they truly didn't know... or the recognize that you aren't just going to let them in.

 

[CAOX3]

Drug seeker?

Murderer?

Not an upstanding human being?

Maybe he is with a relative in the ER and............ummmm and went out to have a smoke and I don't know figured he could get back in the way he walked out.

You guys are like on defcon 5.

 

[Aidey]

That is the most reasonable answer, but as I said, I don't know that for sure, and I don't want to be the person who lets in the abusive parent/boyfriend/spouse/etc who is being kept out for a reason.

 

[systemet]

Should have put him in a rear-naked choke followed by a Bulgarian Armbar.

What's a Bulgarian armbar?

 

[NomadicMedic]

What's a Bulgarian armbar?

10 times worse than a Romanian armbar. And you don't want one of those.

If course, you could always put him in a Bulgarian armoire.


Sent from my iPhone.

 

[Sasha]

After two years as a basic, I've never really run into this before. We had transported a patient and had just brought her into the ED. The exterior door has a numeric keypad as I guess most do. My partner was doing his report, I went out to clean the truck. When I was done I headed back in and there was a guy hanging out by the door. He said "how do you get into this place?" and pretty quickly I figured out he was a drug seeker. I said "you need a code" and blocked the keypad while I entered it.

I went in and of course he followed behind me. I think he bothered a couple of nurses and I'm sure he was ejected eventually. No real harm, although the place was mad-house busy. I asked my senior what I should have done and didn't really get an answer. I could have tried to order him out, I could have shouted "I NEED SECURITY HERE" or I could just think "hey not my problem" but that seems wrong.

What do you do to stop drug seekers or others from piggybacking you into the ED?

Similarly one night I was in the ED and someone else's psych patient bolted for the exit with the medic yelling "hey hey hey! stop him!" which I was not about to do.

"Sorry the patient entrance is over there this is for ambulance personell only"

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[Jon]

Drug seeker?

Murderer?

Not an upstanding human being?

Maybe he is with a relative in the ER and............ummmm and went out to have a smoke and I don't know figured he could get back in the way he walked out.

You guys are like on defcon 5.

Just because I'm paranoid doesn't mean the world really isn't out to get me.

That is the most reasonable answer, but as I said, I don't know that for sure, and I don't want to be the person who lets in the abusive parent/boyfriend/spouse/etc who is being kept out for a reason.

Exactly. And most ED's have that sort of situation on a semi-regular basis.

10 times worse than a Romanian armbar. And you don't want one of those.

If course, you could always put him in a Bulgarian armoire.


Sent from my iPhone.

I think we are getting just a LITTLE off topic.

 

[Sasha]

Civilians aren't allowed in our ambulance entrance or parking area unless they rode in with us, then they go straight out into the waiting room. I would have told him to leave and definitely wouldn't have opened the door with him standing right there.

Hate to say it but that was a bad call dude. How would you live with yourself if he piggybacked in on you and attacked a staff member or a patient?

If someone piggybacked on me into one of the ERs here I'd be in a boatload of trouble. If you were my partner you'd have gotten a stern talking to for that one.

If I was the medic asking for help to stop the pt and you let him run on by a supervisor would be hearing about it. What if the psyc pt was going after a nurse and she was asking for help? Oh yea, its not your job so just let it happen right?

Regarding the psych, did you expect him to tackle him or use himself as a human road block? The most you will get from me when someone decides to run is a "hey stop."

And i have had a rather dangerous psych flee. Right down the road.

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[Shishkabob]

They try to follow me in the ambulance entrance and I tell them that this is for EMS only and they have to go in the main entrance.

 

[Handsome Robb]

You guys are like on defcon 5.

If I'm not mistaken the lower the number the worse the situation...Defcon 5 isn't a huge deal.

Like I said, come hang out in my city for a couple shifts and see why we are sketchy about some of the stuff that happens around ERs.

 

[mycrofft]

Just like the ATM only less so.

Any door labeled "AUTHORIZED ONLY" or with a lock you can open means you go alone unless you are certain the other peson is cleared. If they won't leave or are loitering closely, don't go in or wait for someone else to arrive as well, or call someone to come.
Generally drug sneaks or Munchausens will take off if you show attention, and might get hostile if you confront them. They depend upon not being noticed, or that people will fake ignoring them to avoid an "unpleasant" encounter, as they would a panhandler.

 

[Handsome Robb]

don't Munchausens patients seek attention not run away from it? I know they will go to the worlds end to make themselves or someone close to them sick to gain attention unless I have it backwards?

 

[mycrofft]

Munchausens and Turkey Files

Security will get to recognize them if they are chronic, so they will try to slip in. Also, a way to try to slip ahead of the line.

 

[Nerd13]

Depending on how close the front door is to the ambulance bay and how well lighted it is there is always the "Here, let me show you where the front door is" route. Obviously that may be a safety concern. If I don't feel safe walking them to the other door then I'm probably not going to loiter around in the ambulance bay with them either. Grab the keys to the rig and go in the front door yourself. Gets you out of the complicated situation and gives you someone to alert to the fact that there is someone shady standing outside the ambulance bay.

 

[Tigger]

If I was the medic asking for help to stop the pt and you let him run on by a supervisor would be hearing about it. What if the psyc pt was going after a nurse and she was asking for help? Oh yea, its not your job so just let it happen right?

Really? You would tell my supervisor that I failed to attempt to stop someone that was in protective custody from fleeing despite not being trained in any sort of legitimate take down and hold techniques?

I can't really imagine my supervisor taking that very seriously, I think he would be quite happy that the company is not paying me workman's comp as a result of that confrontation. Recently my partner did chase down and detain a psych patient that escaped as I was doing my PCR. We thought it was humorous, the boss did not.

And this isn't in some rural area. Lot's of us work in urban areas with their fair share of violent crime.

 

[MediMike]

I'm gonna run this one a little farther off topic by following up on the psych statement. Tigger you hit it right on the head partner. I'M not a security guard, cop, Air National Guard or RCMP. It's NOT my job to tackle some crazy :censored::censored::censored::censored::censored::censored::censored: running by me, nor am I legally protected if I do so. I will assist PD in they request it, as they are "brothers in arms" for lack of a better term, but there is no way in hell that I'm taking the physical or legal responsibility of going after someone on my own.

(Although...+1 to the sticking out the leg and tripping idea)

 

[jjesusfreak01]

Depending on how close the front door is to the ambulance bay and how well lighted it is there is always the "Here, let me show you where the front door is" route.

I would do this. Most of our ERs have security by the walk-in entrance, so I would offer to show him to the entrance, and if he refused I would walk around anyway to let security know (although the last time I saw a loiterer around the EMS entrance security had already seen him on the cameras and was looking for him). I also have the privilege of never having to stop for metal detectors when in uniform, so i'd walk through the entrance and he'd likely be stopped regardless.