how to reassure hysterical patients?

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emt123

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lets say in theory you have a patient who has suffered some major trauma (car accident) and on scene you have her kid who is hysterical, balling etc. Obviously you can't tell him it will all be okay, but what do you say to him? Or a situation where someone who has been moderately injured is screaming, crying etc and it is spiking her BP/heart rate and making her worse. How can we as EMTs be more reassuring, and get patients to trust us more?
 
I personally would probably get the child out of the car away from the mother due to the extent of the injury with another crew member or PD and inform the mother that her child is being taken care of. Also if the mother or parent that is injured and able to speak i would ask if there is a person who we could call to come pick the child up assuming the child isnt injured, so that the child is with someone he/she is comfortable with.
 
You do not want to give the patient false hope if there is a serious situation at hand. When a patient is concerned about a parent, friend, loved one etc. I focus on the facts and inform the patient that their loved one is being taken care of by another medic, and that they are being given the highest level of care. What I try to do, is focus the conversation back on the patient and their specific needs that we are taking care of and addressing. I do however reassure that their loved ones are in good hands.
 
Stat12Lead said:
You do not want to give the patient false hope if there is a serious situation at hand. When a patient is concerned about a parent, friend, loved one etc. I focus on the facts and inform the patient that their loved one is being taken care of by another medic, and that they are being given the highest level of care. What I try to do, is focus the conversation back on the patient and their specific needs that we are taking care of and addressing. I do however reassure that their loved ones are in good hands.
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I agree i would not give false hope because thats something you just dont do, but if the child is fine after being assessed by another Medic then i would probably do what i said earlier.

All you really can do to a patient who is injured that is screaming and crying is let them know that you and your crew members are doing everything possible. Thats all you can really say even if they ask you "Am i going to be ok?" Comfort them to the best of your ability without give the patient false hope.
 
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We all have our preferred ways of calming down people who are freaking out...

lets say in theory you have a patient who has suffered some major trauma (car accident) and on scene you have her kid who is hysterical, balling etc. Obviously you can't tell him it will all be okay, but what do you say to him?
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Nothing....grab the patient and get the heck out of there. Let the cops, other EMS personnel or the firefighters on scene worry about someone who is effectively a bystander (assuming they are not also injured). In a serious trauma, like it or not, sometimes coddling a kid is going to waste time and energy you should be expending taking care of the patient. Remember, the person screaming the loudest is probably the least critically injured (taught to me as "Bazier's Law of Inverse Volume").
 
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As USAF said. But if you are in a situation where you're not needed for patient care and such, a good tidbit I found in researching managing SIDS cases was to let them know they did a good job. For example, if someone's dad/son/grandma/whoever is hurt really bad, and the bystander called 911, did CPR, whatever, you can tell them that they are in the best of hands and they're trying to do everything they can, and that you all appreciate the help they gave prior to your arrival.


I had a hysterical autistic kid once with a sprained ankle. Having him "breathe with me" helped a lot, because he was hyperventilating. I've used that trick before quite a bit with anxiety attacks, asthmatics who are working themselves up, etc. Just breathe deeply in through your nose and out through your mouth, dramatically so they can hear/see, and tell them to breathe with you.
 
LucidResq said:
As USAF said. But if you are in a situation where you're not needed for patient care and such, a good tidbit I found in researching managing SIDS cases was to let them know they did a good job. For example, if someone's dad/son/grandma/whoever is hurt really bad, and the bystander called 911, did CPR, whatever, you can tell them that they are in the best of hands and they're trying to do everything they can, and that you all appreciate the help they gave prior to your arrival.


I had a hysterical autistic kid once with a sprained ankle. Having him "breathe with me" helped a lot, because he was hyperventilating. I've used that trick before quite a bit with anxiety attacks, asthmatics who are working themselves up, etc. Just breathe deeply in through your nose and out through your mouth, dramatically so they can hear/see, and tell them to breathe with you.
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One of the techniques, I also use on the anxiety/hyperventilating Pt. is to have the hold onto my hands. I tell them to hold their breath as I squeeze their hands. I squeeze their hands for 2 sec. and tell them to hold their breath. With a calm voice, I then stretch the time to 4 sec, 6 sec. and so on. This positive feed back works and makes you look like a hero.
 
Ultimately, freaking out lives either in the past ("That was terrible!") or the future ("We're all gonna die!").

Assuming the person who is truly injured is being taken care of, the key is to ground the person in distress in the present moment..."This is what's happening now. How are you doing right NOW? Can you feel this (pressure on hand) Now? I'm right here with you Now!"

(Previous post was an excellent example; building to make the moments of clarity longer.)
 
Well, assuming that the patient is being taken care of and your services are not immediately needed in their care and/or transport I find the best thing to do in those situations is to find another family member, friend, or someone else who's "personal" to that bystander and have them just "be close" to them and try to talk to them. This is especially the case with kids, and particularly the ones that are on the younger end of the "school age" (6-10) category and below. There really is very little you can do as a "stranger" (how little kids will see you) or someone whom is just not known personally to make them feel better. You don't know them and they don't know you, and the best thing they can get in these times is something or someone "familiar" to them. Your best bet is just to take a step back and let family and friends care for the emotionally distraught. If you have toys on your rig, you can try giving one to the kid to play with once they've calmed down a bit, but in my (admittedly limited) experience that's about all you can do.

Now, for adults or adolescents it's usually a bit more manageable. As always it depends on the context, but for the anxiety/hyperventilation calls usually just coaching them through relaxation/breathing techniques is sufficient to resolve the issue. Easier said than done in some cases though.
 
emtstudent04 said:
I personally would probably get the child out of the car away from the mother due to the extent of the injury with another crew member or PD and inform the mother that her child is being taken care of.
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Yeah, I will not miss that so much. I have had that role a few times as FD on some bad calls. Once I was FD but asked to drive the rescue as all the EMT's were needed to tech the calls in the back and I had a hysterical wife in the front. Code 3 in a blizzard is bad enough.

I am waiting for my license to come in the mail so I can be in the back, not driving!

usafmedic45 had the best advice. Focus on the patient, let some other kind soul worry about the family.
 
MonkeySquasher said:
"Sniff the flowers, blow out the candles"
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I like that, mind if I steal it?

I've been volunteering at a school, and a lot of the kids get really upset over pretty minor injuries, I find disctracting them usually works pretty well. Either giving them somthing minor to do so they feel like they're helping or asking them about sports or games they play seems to work pretty well for me.
 
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