Psych Hold - How do you assess?

hibiti87

Forum Crew Member
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i agree with report first. If the nurse defaults to" i just got on" which is in most cases, after ill read the 5150 report, talk with security, check level of restraints, then make my initial assessment. Of course always make sure the pt is medically cleared to go, JGP is more then happy to turn you away for sudden chest pain. :unsure: maybe i shouldnt have said that for all you potential 5150s.....
 

airborne2chairborne

Forum Crew Member
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I agree with the overall consensus of getting a report from a nurse first... but that depends on the facility. There's some places (hospitals included) where I'd take the word of a janitor over the head nurse, and you get your fair share of medical personel ranging from EMT-Bs to MDs who are burned out and will just check off a generic box without really checking. So nothing wrong with doing your own assessment. Security guards for some reason think they have a medical say in matters. They don't, if one tries to tell you how to do your job tell him to go :censored::censored::censored::censored: himself and to go away before you have your dispatcher hit up the REAL police about him interfering with your patient care. Finally, nurses seem to forget that if they're giving you a patient then once you sign for him/get him on your gurney he's YOUR patient, not theirs anymore. They're not on your medical chain of command by any means and don't have the same protocols. So unless an MD is chiming in with them about you being wrong, who cares?
 

TheLocalMedic

Grumpy Badger
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Thank you, 18G for mentioning getting a report first. Always always always talk to someone before you make patient contact for IFTs.

And be careful with psych patients! I worked at an IFT company for several years and a good portion of our transfers were of the psychiatric variety. I was always pretty relaxed about these guys, and few ever gave me any trouble. (But then again, I'm 6'1'' and 270, built like a Mac truck) But I did have one patient (a twerpy teenager too) who damn near killed my partner and I. I was lucky enough to escape with a few broken ribs, but had I not been quite as quick I would have had a nice stab wound in the chest from the scissors he had concealed on him too. Now, I generally restrain any and all psych patients. Too bad for them, life sucks when you're crazy, and I apologize to no one.

Also, all of those questions you asked, like about having a plan or suicidal ideation? Yeah, the hospital already asked about all that. Not really your place. And why do you need to know? All you need is their diagnosis, their complaints, and whether or not you should just restrain them or really really restrain the crap out of them. Yeah, sure it might be interesting, but unless you have some actual psych training those things have no bearing on how you will deal with this patient. And it's awkward.
 
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