patient approach

NysEms2117

ex-Parole officer/EMT
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I know there was a thread on what you say to a patient when you first approach them, for this thread I would like to talk about the following: Body language, angles of approach, style(hesitant, or arms wide open), along with any other things you'd like to add.

Personally my style is most likely different then everybody from my main job training. My body language is very defensive/ skeptical, my angle of approach is always from the side(provided there is no head or neck trauma suspected if thats the case obviously from the front so they dont try to move and make it worse), my style is very hesitant, looking at hands, waist, the way their back moves(if they are moving), ankles, and all the "key spots" LE focuses on. I also approach with my partner 9/10, very rarely does one of us go ahead/ stay behind to get equipment.
 

PotatoMedic

Has no idea what I'm doing.
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It depends on what the situation is. Where I work I do a mix of 911 and interfacility. 911 depends on the area and the dispatch. Interfacility depends on where I'm picking up (either er or floor or medical office), where I'm going (er or floor or psych facility or home etc.) And what the call is for. Also a lot changes on how the pt interacts with me. I 99% of the time start it off with hello my name is ... And based on how they respond changes my demeanor. Usually I don't get within arm's reach until I have said hello for their comfort and my safety. I can be sweet or I can be stern, joking or serious. All depends on how the first interaction goes. And as always I reevaluate how to interact with a patient and the encounter goes.

Really the only thing I do every time is say hello my name is xyz and, use past experiences to guess how a situation may go but always be open to handling things differently.
 

EpiEMS

Forum Deputy Chief
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I'm lucky in that PD responds first to (nearly) every call in my area. I love the added security (and frankly, the implied threat that if we think you should go to the hospital and you don't, you'll be forced to go can be very helpful).

That being said, I don't think a defensive approach is necessary 100% of the time. Picking up a patient from a SNF or medical office doesn't really imply much of a risk (unless we're talking about some sort of behavioral issue), but there is definitely an added risk any time we go into somebody's house.

I like the idea of always approaching in a group (where possible) and keeping an eye on ankles/wrists/hands/small of the back, etc.
 

Tigger

Dodges Pucks
Community Leader
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I am a healthcare provider. Most of my patients call me because they have a healthcare need. I don't treat them like a threat, I treat them like I care.

I'm not a cop and I don't pretend to be one on EMS calls. Occasionally a patient may present in a shadier manner which might change my approach, but for the most part, I approach patients like my PCP approaches me in the office, friendly, reassuring, and here to help. I don't need to posture up on people who asked for our help.
 
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NomadicMedic

I know a guy who knows a guy.
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I am a healthcare provider. Most of my patients call me because they have a healthcare need. I don't treat them like a threat, I treat them like I care.

I'm not a cop and I don't pretend to be one on EMS calls. Occasionally a patient may present in a shadier manner which might change my approach, but for the most part, I approach patients like my PCP approaches in the officer, friendly, reassuring, and here to hope. I don't need to posture up on people who asked for our help.

^^^^ This. 1000x, this.
 
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NysEms2117

NysEms2117

ex-Parole officer/EMT
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909
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I am a healthcare provider. Most of my patients call me because they have a healthcare need. I don't treat them like a threat, I treat them like I care.

I'm not a cop and I don't pretend to be one on EMS calls. Occasionally a patient may present in a shadier manner which might change my approach, but for the most part, I approach patients like my PCP approaches in the officer, friendly, reassuring, and here to hope. I don't need to posture up on people who asked for our help.

Idk if my wording was off or if I'm just that cynical. But I can Definitely see where your coming from. It's been kind of engraved in my head to be overly cautious until proven otherwise. I treat them like I care, but after I've made sure I and my team/partner won't get hurt in the process


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Tigger

Dodges Pucks
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My body language is very defensive/ skeptical, my angle of approach is always from the side(provided there is no head or neck trauma suspected if thats the case obviously from the front so they dont try to move and make it worse), my style is very hesitant, looking at hands, waist, the way their back moves(if they are moving), ankles, and all the "key spots" LE focuses on. I also approach with my partner 9/10, very rarely does one of us go ahead/ stay behind to get equipment.

Idk if my wording was off or if I'm just that cynical. But I can Definitely see where your coming from. It's been kind of engraved in my head to be overly cautious until proven otherwise. I treat them like I care, but after I've made sure I and my team/partner won't get hurt in the process

You approach your patients like a police officer approaches and individual he suspects has done something wrong. That's what I got out of your first post.

I suppose I can't really find fault with that, but I think it's wholly unnecessary and probably disconcerting for patients. Tough to feel comfortable with someone when they're eyeing you like they did something wrong.

It's important to stay cognizant of scene dynamics, but assuming that every patient is a threat is a silly practice.
 
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NysEms2117

NysEms2117

ex-Parole officer/EMT
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You approach your patients like a police officer approaches and individual he suspects has done something wrong. That's what I got out of your first post.

I suppose I can't really find fault with that, but I think it's wholly unnecessary and probably disconcerting for patients. Tough to feel comfortable with someone when they're eyeing you like they did something wrong.

It's important to stay cognizant of scene dynamics, but assuming that every patient is a threat is a silly practice.

Any suggestions as to how I should "flip that switch" I don't see absolutely everybody as a threat, but calls that aren't ift's I just get super skeptical. Obviously if they're laying pinned under a car or having a heart attack I'm not going to "size them up". But if it's an unknown from a house and we go in I don't just March to the patient.


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Tigger

Dodges Pucks
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Any suggestions as to how I should "flip that switch" I don't see absolutely everybody as a threat, but calls that aren't ift's I just get super skeptical. Obviously if they're laying pinned under a car or having a heart attack I'm not going to "size them up". But if it's an unknown from a house and we go in I don't just March to the patient.
It sounds corny, but I treat people like I would treat my Grandma.

Part of EMS is going into people's homes. Sometimes we don't have all the info, and if we have nothing I stage and have PD go in first (yes, even in at my city job we can get a cop for that). But remember, they called you for help. Yes, there have been ambushes. But that is incredibly unlikely. I pay attention when I walk into someone's house, but I am not waiting to be shot at either.

On most calls there just isn't a lot to be skeptical about. They. Called. You. For. Help.
 
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NysEms2117

NysEms2117

ex-Parole officer/EMT
1,946
909
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It sounds corny, but I treat people like I would treat my Grandma.

Part of EMS is going into people's homes. Sometimes we don't have all the info, and if we have nothing I stage and have PD go in first (yes, even in at my city job we can get a cop for that). But remember, they called you for help. Yes, there have been ambushes. But that is incredibly unlikely. I pay attention when I walk into someone's house, but I am not waiting to be shot at either.

On most calls there just isn't a lot to be skeptical about. They. Called. You. For. Help.

I can/will try that. Not trying to be argumentative, but don't they call police for help too?


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EpiEMS

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I can/will try that. Not trying to be argumentative, but don't they call police for help too?

I think the way to think about it is this:

People call 911 because they are scared. People want the police to protect them from other people (or maybe a wild animal), and people want the fire department to protect them from a fire (or other potentially deadly but definitely property-damaging thing). People call EMS because they feel weird and don't know why, want a ride to the hospital, or because they were told to (by their PCP, say). People don't typically call EMS to hurt us.

The biggest danger in EMS is a MVC. Patients attacking, sure, it happens - but most of the time, they're not a threat.
 

Tigger

Dodges Pucks
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I can/will try that. Not trying to be argumentative, but don't they call police for help too?


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Because they are threatened by something. They call us because in their own mind they are sick or injured.

When you have the flu, do you enjoy having your mother/GF/wife/other SO look at you warily or do you prefer they show empathy?
 
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NysEms2117

NysEms2117

ex-Parole officer/EMT
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909
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Because they are threatened by something. They call us because in their own mind they are sick or injured.

When you have the flu, do you enjoy having your mother/GF/wife/other SO look at you warily or do you prefer they show empathy?
i mean i'd like the empathy, but i'll take what i can get lol
 

StCEMT

Forum Deputy Chief
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Take this for what it's worth, but I have had more red flag moments with people who aren't my patient than my patient. I have restrained one person and then a partner and I had to draw some lines for another, but that's about it. Otherwise it has been psychs in a hospital get riled up near my patients or recently a agitated boyfriend riding along that I think had some psych issues more often than my patients be the problem. With the first, my partner and I just put ourselves between them and the patient and stand back and the latter I just quietly pulled security aside when we parked.

Like firewa said, I will do the normal intro and from there I can usually tell how I need to proceed. Usually it is simply just be more cautious, but I don't need to directly do anything.
 

DrParasite

The fire extinguisher is not just for show
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When you have the flu, do you enjoy having your mother/GF/wife/other SO look at you warily or do you prefer they show empathy?
Actually, I prefer that she leaves me alone, because I get cranky (and damn near intolerable) when I'm sick, and typically just want to sleep, and recover until my body has removed the offending virus or bacteria.

I have to agree with what Tigger said. If you come in defensive/skeptical, you can get a defensive/skeptical response. That being said, work with your partner, and remember just because one person wants you to help them, doesn't mean everyone in the house wants you there.
 
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