Psych pts

Qulevrius

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Your company requires you to restrain all psych patients?
5150s ? You betcha. As a matter of fact, I’d like to see any county in CA that doesn’t have restraints for involuntary psychs in their respective EMSA protocols.
 

DrParasite

The fire extinguisher is not just for show
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5150s ? You betcha. As a matter of fact, I’d like to see any county in CA that doesn’t have restraints for involuntary psychs in their respective EMSA protocols.
Another reason i'm very glad to have never worked in CA.... my agencies actually trust me to use my clinical judgement when it comes to the application of restraints. I bet you give every medical patient a NRB at 15 LPM, and every trauma must be strapped to a backboard right?

So no, I have never restrained 100% of my psych patients, and most psych patients I have handled aren't involuntary. And its not in any state protocol to require all psych patients to be restrained.
 

iExposeDeformities

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Another reason i'm very glad to have never worked in CA.... my agencies actually trust me to use my clinical judgement when it comes to the application of restraints. I bet you give every medical patient a NRB at 15 LPM, and every trauma must be strapped to a backboard right?

So no, I have never restrained 100% of my psych patients, and most psych patients I have handled aren't involuntary. And its not in any state protocol to require all psych patients to be restrained.
I’ve heard being on 15 LPM on NRB is like sticking your head out the window of a moving car. That’s definitely gonna worsen a lot of patients conditions where they don’t need it whereas not putting a restraint on some psychs won’t necessarily make a lot of difference so it’s really not analogically the same
 

Qulevrius

Nationally Certified Wannabe
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Another reason i'm very glad to have never worked in CA.... my agencies actually trust me to use my clinical judgement when it comes to the application of restraints. I bet you give every medical patient a NRB at 15 LPM, and every trauma must be strapped to a backboard right?

So no, I have never restrained 100% of my psych patients, and most psych patients I have handled aren't involuntary. And its not in any state protocol to require all psych patients to be restrained.
I can’t decide what I find more curious - your inability to comprehend written text or your affinity for baseless ad hominem attacks.
 

Bullets

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5150s ? You betcha. As a matter of fact, I’d like to see any county in CA that doesn’t have restraints for involuntary psychs in their respective EMSA protocols.
Even if they arent violent? You restrain cooperative patients? I dont think thats really great for their mental health
 

Jim37F

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I've worked for companies that required restaining 100% of all 5150 (psych) patients, regardless. Yes, even the calm, cooperative ones. Yes, I hated it. I explained it was a policy outside my authority and loosely restrained the minimum to comply with the requirement and all the patients I had in those cases didn't make a fuss.

That being said, it's certainly not an LA County requirement to restrain every psych as the majority of places I worked there did not have that requirement. I am aware of more than a few employers who have those policies but I am not aware of any of the county LEMSA's dictating those policies be in place county-wide.
 

Qulevrius

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Even if they arent violent? You restrain cooperative patients? I dont think thats really great for their mental health
1) Which part of ‘County EMSA Policy in regards of restraining involuntary psychs’ confuses you ?

2) Are you a trained, qualified & licensed mental health professional ?
 

EpiEMS

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As a matter of fact, I’d like to see any county in CA that doesn’t have restraints for involuntary psychs in their respective EMSA protocols.
Not to get involved in a...heated discussion, but I'm quite curious - why would it be mandatory to physically (or chemically?) restrain a person with a psychiatric problem who is being treated against their will? Plenty of folks get treated against their will without being violent or posing a risk of harm.
 

Qulevrius

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Not to get involved in a...heated discussion, but I'm quite curious - why would it be mandatory to physically (or chemically?) restrain a person with a psychiatric problem who is being treated against their will? Plenty of folks get treated against their will without being violent or posing a risk of harm.
The only person who can answer that for you would be the county’s medical director.
 

DesertMedic66

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My county and company also require restraints on 100% of patients on a 5150 hold (72 hour psych hold) with no exceptions. It doesn’t matter if the patient is 9 or 99, calm or aggressive.
 

Bullets

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1) Which part of ‘County EMSA Policy in regards of restraining involuntary psychs’ confuses you ?

2) Are you a trained, qualified & licensed mental health professional ?
I didnt understand that your county can set policy for an agency that it doesn't directly control. Not being familiar your local EMS system and all. We dont have county based, well pretty much anything, here. Each agency has a medical director who sets our clinical best practices.

my medical director i guess trusts me any my staff to, as you said, "Not shotgun everything". We view restraints as a treatment, with clinical criteria for such. Just making a statement that activates a hold isnt criteria for such, just as saying "i have chest pain" isnt automatically getting 15LPM NRB O2.

Im not trying to attack you personally, it just seems shocking to me that such a policy existed in such a wide area.
 

EpiEMS

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The only person who can answer that for you would be the county’s medical director.
So that's a policy coming from medical direction/protocol, ok. Seems a little unjustified...
Just to note, looking at protocols for the 2 most populous counties in CA, San Diego and LA , I don't see any requirement to restrain, and they both have some variant of what I would call the reasonable policy of 'restrain only if necessary to prevent the patient from being injured/injuring others'. I'd be curious to see a policy stating that everybody gets restraints -- and the language used to justify it.
 

DesertMedic66

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So that's a policy coming from medical direction/protocol, ok. Seems a little unjustified...
Just to note, looking at protocols for the 2 most populous counties in CA, San Diego and LA , I don't see any requirement to restrain, and they both have some variant of what I would call the reasonable policy of 'restrain only if necessary to prevent the patient from being injured/injuring others'. I'd be curious to see a policy stating that everybody gets restraints -- and the language used to justify it.
Here is our protocol:

A22BCD7B-2599-4A7C-89D9-3A80EBADF889.png
 

Qulevrius

Nationally Certified Wannabe
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So that's a policy coming from medical direction/protocol, ok. Seems a little unjustified...
Just to note, looking at protocols for the 2 most populous counties in CA, San Diego and LA , I don't see any requirement to restrain, and they both have some variant of what I would call the reasonable policy of 'restrain only if necessary to prevent the patient from being injured/injuring others'. I'd be curious to see a policy stating that everybody gets restraints -- and the language used to justify it.
Not every psych is a 5150, but all 5150’s are involuntary psychs. If it’s a voluntary psych, the county’s guidelines are ‘restrain if/as needed’. Bit if it’s a 5150 who is, by definition, an involuntary psych and danger to himself and/or others, the only difference between counties is how many restraints they should have. REMSA and OCEMSA require 4-points, LACo and VEMSA require 2-points etc. As I said, I’ve yet to hear about any county in CA that does not have mandatory restraints for involuntary psychs in their protocols.
 

NomadicMedic

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In reading that riverside policy, it clearly says "physical restraints are to be used in necessary".

In reading that, it seems as though when you transport a 5150, IF RESTRAINTS ARE NECESSARY, you need to use 4 points.

Am I missing the point?
 

DesertMedic66

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In reading that riverside policy, it clearly says "physical restraints are to be used in necessary".

In reading that, it seems as though when you transport a 5150, IF RESTRAINTS ARE NECESSARY, you need to use 4 points.

Am I missing the point?
The county and company view it as anyone on a 5150 hold makes it necessary.
 

NomadicMedic

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The county and company view it as anyone on a 5150 hold makes it necessary.
Thats a pretty poorly written protocol.
If the patient MUST be transported in 4 point restrains as a nonnegotiable, it should state that. However, it states, in the heading, restraints should only be used if necessary. A calm, cooperative patient does not require restraint.

I’d probably pitch a stink about that.
 

DesertMedic66

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In reading that riverside policy, it clearly says "physical restraints are to be used in necessary".

In reading that, it seems as though when you transport a 5150, IF RESTRAINTS ARE NECESSARY, you need to use 4 points.

Am I missing the point?
It is poorly written however it is implied as “these are the conditions when it is necessary: danger to themselves/others, 5150 hold, in PD custody”. Company policy backs it up.
 

soloBLS

Forum Ride Along
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just affirm there's no medical need for transport and have the cops take them ¯\_(ツ)_/¯
 

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