Self-Defense for EMS providers

[DT4EMS]

There is always a ton of questions surrounding EMS Self-Defense. Maybe I can offer some help.

Have you wondered "What would I do if....." ?

People have told you to "follow the law" when it comes to patient restraint. Do you know what the law is? (Depends on your state, but most have similar guidelines)

Can you hit someone with an O2 Bottle in self-defense? ( I would warn against it, but it is not totally wrong)

Could you use your trauma shears to defend against a knife? (Yes)

Could a 125 lb female EMT use more force (improvised weapon) against an attacker sooner than a 200 lb man? (Yes)

Is being assualted "part of the job?" I say NO! Would it be OK if you worked at Mcdonalds and a guy reached across the counter and grabbed or smacked you? What if you worked in a bank? What would happen to that person?

Please don't confuse self-defense with dealing with an uncooperative patient.
EMS providers are already doing a great job overall in dealing with uncooperative patients.

If you have been assualted in the field, please share your story. If you are wondering "What would I do if...." maybe I can offer a suggestion or a comment.


I am not trying to hack anyone off, just starting a discussion.

 

[rescuecpt]

I was assaulted by an AMS patient. Long story, but she didn't end up physically harming me, and although she pushed me several times, I felt that I was actually in control of the situation. I could have put her down on the ground whenever I wanted but at that point I felt it wasn't necessary (I have several years of self-defense training tucked in my back pocket). Some firefighters and a police officer got involved and she stopped almost immediately - it wasn't them she didn't like, just me.

 

[DT4EMS]

That has been my point a lot of times. The more training a person receives, the less they tend to use it. There is no need to "prove" anything.

I had a guy the other day that I had to take down pretty hard. After it was all done (but the paperwork) he started talking crap about how he "could crush your throat" break my knees and all that. I told him that I appreciated the fact he didn't beat me up in front of everyone.

He then siad I was mocking him. I simply replied that I wasn't mocking him, but agreeing with him. I asked him what would he say if I said I could kick his butt. Then we would be in an arguement.

He started to reply, went "Hmmm" and shut up.

 

[vtemti]

Originally posted by rescuecpt@Jul 8 2005, 09:59 AM
- it wasn't them she didn't like, just me.

We had a frequent flyer that was the same way. He would be fine (especially with the women) until I showed my face then he would go off the deep end. I wonder what he would have thought if he knew that on most of the calls where he didn't think I was around, I actually had his life in my hands behind the wheel.

 

[Nikki320]

I would actually like to learn how to defend myself better. I would like to feel confident that at any given moment if someone attacked me i could feel confident to defend myself, i'm a strong girl but in all honesty i don't know how to "lay someone out" as some as you guys say. I mean sure i could defend myself with a pair of trauma sheers but as far as using my own body to defend myself i don't know. If i ever decide to go into tactical ems then ofcourse i will be taught how to defend myself etc, but in the mean time what type of class would you guys recommend for me?

 

[vtemti]

I know that in our area anyway, "Self Defense for Women" courses are sometimes offered. Very basic stuff, but unless you want to get into a martial arts program or you do get more training, it could help save your butt.

 

[Wingnut]

My husband taught me some wrestling and akido a while ago, and while in the academy he taught me all the tactics they use, so I'm pretty comfortable with the basics. I just hope I never have to use them. If I ever get the time, I would LOVE to take a martial arts class. I'll have to add it to my list of One of these days...

 

[DT4EMS]

Originally posted by Nikki320@Jul 9 2005, 10:33 PM
I would actually like to learn how to defend myself better. I would like to feel confident that at any given moment if someone attacked me i could feel confident to defend myself, i'm a strong girl but in all honesty i don't know how to "lay someone out" as some as you guys say. I mean sure i could defend myself with a pair of trauma sheers but as far as using my own body to defend myself i don't know. If i ever decide to go into tactical ems then ofcourse i will be taught how to defend myself etc, but in the mean time what type of class would you guys recommend for me?

I mean sure i could defend myself with a pair of trauma sheers but as far as using my own body to defend myself i don't know. If i ever decide to go into tactical ems then ofcourse i will be taught how to defend myself etc, but in the mean time what type of class would you guys recommend for me?

Train in any style that teaches escapes. You don't need to try and learn to trade punches with anyone. I have trained most of my life, but I still don't plan on kickboxing on the street. I strike only to create space or create a distraction to set up something else. Remeber that the person that will attack an EMS Provider will most likely be high, drugged or mentally unstable. So the average "pain compliance" techniques are usually ineffective on those kind of people.

Look at the video on the www.dt4ems.net website and you will see little petite women defending (escaping) all kinds of grabs and holds at high speeds. There are several different places(other than DT4EMS) that teach contact self-defense.
No matter what, try to train somewhere. It will help with physical fitness, stress reduction and help you function under the high stress of a potentially violent encounter.

EMS Providers should concentrate on training "Reaction and Power" to prepare for an escape move. It is not an EMT or Medic's job to fight. But you have to possess some type of skill to prevent you from going overboard in the event you are forced to defend yourself.

 

[Nikki320]

Thanks a lot i noticed that there is a self defense for women class at my college so i will probably take that when my schedule isn't so busy. I want it not only for EMS but just so i can feel more confident in my ability to defend myself.

 

[vtemti]

That would be a good start. If I remember correctly they consentrate more on conteracting an attackers agression rather than teach offensive type moves. Would be very helpful in the EMS setting and everyday life. h34r: (just getting ready)

 

[Stevo]

[aside]iirc, we've had our share of larger individuals violently siezing that were enough trouble[/aside]

 

[DT4EMS]

It is important to note that when it comes to self-defense, not being in a bad place in the first place is THE BEST DEFENSE. The problem with that theory is historically when EMS providers ARE attacked, they had no prior warning.

I will tell you that even in my police job, I will talk way longer than other officers will in an attempt to not use force. So you can imagine what I will deal with on an ambulance. But if I am forced to use it, I don't waste time and I don't trash talk when it is done.

Simple steps like placing yourself in a tactically safer place on the benchseat and using ALL the straps on the stretcher can "Buy you a second" to make a decision in a bad situation. Like I said before, it is not the initial action of the provider that gets them in trouble during self-defense, but the actions that follow.

The hardest part of working out is getting dressed. If you will commit to getting dressed for your workout, you will motivate yourself to go.

 

[CodeSurfer]

This has actually been an issue with me in the past couple weeks. I was not yet cleared to drive the ambulance and my partner and I had gotten a few 5150 interfacility transfers that stated the PT was a danger to others. We arent allowed to restrain the pt if they are not uncooperative or behaving in a threatening way and in both instances the patients were calm and collected when we arrived on scene. This left me in the position where I would be in the back with unrestrained 200+ lbs male pt's on psych hold for being a danger to others (because my partner had to drive)

So in this situation, how would you approach it? My reasoning led me to ride up front and have the patient in the back. My logic was that me being in the back would not prevent this patient from fleeing if they chose to because theres no way I would try and stop him. Even if I wanted to stop the pt I wouldnt be able to, and being back there alone with them would put me at risk.

Fortunately I am cleared to drive now and this will no longer be a problem, my parter is a big guy trained in some kinda martial arts so if we ever get another call like this it will be his pt. Just curious how ppl here would have handled the situation.

 

[DT4EMS]

Originally posted by CodeSurfer@Jul 14 2005, 12:54 AM
This has actually been an issue with me in the past couple weeks. I was not yet cleared to drive the ambulance and my partner and I had gotten a few 5150 interfacility transfers that stated the PT was a danger to others. We arent allowed to restrain the pt if they are not uncooperative or behaving in a threatening way and in both instances the patients were calm and collected when we arrived on scene. This left me in the position where I would be in the back with unrestrained 200+ lbs male pt's on psych hold for being a danger to others (because my partner had to drive)

So in this situation, how would you approach it? My reasoning led me to ride up front and have the patient in the back. My logic was that me being in the back would not prevent this patient from fleeing if they chose to because theres no way I would try and stop him. Even if I wanted to stop the pt I wouldnt be able to, and being back there alone with them would put me at risk.

Fortunately I am cleared to drive now and this will no longer be a problem, my parter is a big guy trained in some kinda martial arts so if we ever get another call like this it will be his pt. Just curious how ppl here would have handled the situation.

Every call you go on has potential dangers, Dogs, cars crash etc. The unique things about dealing with behavioral emergency "transfers" is you have prior knowledge that their is a chance your safety could be at risk.

If the transfering facility has not medicated/restrained the patient before you arrived, there is a god possibility there will be no problems with you trip.

But lets say you are going down the road, the guy started freaking out and tries to escsape out the back doors. What do you do?

Let's make it worse. He freaks out and starts telling you he is going to kill you, but intead of trying to get out the back doors, tries to come after you. What do you do?

Now, either one of these is a bad deal if the patient is in the back alone.

Here is how I have handled these in the past.

First, when taking over the patient care from the hospital, get a good report of the patients' history (violent, depressed etc).

Talk to the patient. Make good eye contact and be professional. Appear in control, without acting like "John Wayne".

When the patient gets on your stretcher, explain that it is for "safety" they are strapped on. Most newer stretchers have shoulder straps, USE THEM. They cn "buy you a second" to escape if need be.

Place the leg straps just above the knees. In martial arts we teach to control a limb, you must control it's middle joint. Placing the straps just above the knees will again "buy you a second" to move on.

When you sit on the bench seat, sit in a "tactically safer" position just about the level of their shoulder. From here you could do "Elbow Control" if needed long enough for your partner to "STOP" the ambulance and let you out if need be.

As far as being in the back, the patient wanting out........consider it. Start having your partner get on the radio or cell phone while you try and stall the patient. If you do not have time, because they jumped up and started heading for the door.......

Try to stop them with words. DO NOT GET BETWEEN THEM AND THE DOOR! You can be pushed out while moving down the road. It takes a minimum of 5 people to properly medically restrain a viloent patient. So what are you going to do by yourself, moving down the road, with a patient twice you size?

Anyway, the tactics you employ prior to the incident can buy you some time, to have your partner slow down or stop, get more help on the way, make decisions to restrain or escape etc.

 

[Jon]

I belive that if the patienty wants to get out, I'll let them get out.... if jumping out the back door while doing 70 down the expressway sounds like fun to them, fine... I'll sit here in the airway chair and watch...........


Great suggestions, DT. I am the other way around, codeSurfer, as I'm the big 300lb EMT who gets to ride the REALLY CRAZY guys.... one reason I wore body armor while working overnight transport EMS in the city... I've been kicked and punched (by patients) a few times, and it never hurts to have that padding. I've seen medics beaten up by EDP's.

As for transferring facility giving info, I've had fights with some local facilities that love to hide behind HIPPA. I ALWAYS get a report when tranferring a pt - even if it is nothing more than "I'm here to take Mr. Jones to dialisys, how has today been... anything happening with him?" For Psychs, some of the local facilities SEAL the patient's chart and transfer sheet, only giving us their intake sheet with CC, basic PMH, sometimes meds, and insurance and address info. I would always ask about every patient (voluntary and involuntary) how they had been acting, basic info on pharmacologic interventions (did he get a little ativan, or get knocked out by an almost OD of Haldol and thorazine?) basic PMH - Psych and non-psych, and "any issues I need to know about for the transfer?" (things like.... doesn't like loud noises, fears darkness, hates women, or seeing UFO's would come out here...) and "anything else I should know?"

The facilities I've delt with haven't had issues with these questions once they got to know me and learned that I didn't care what was in the sealed emvelope, so long as I never got burned by a missing/bad transfer sheet, and was told what I needed to know to safely manage the patient.

I absolutly HATE having someone in my rig for a routine transfer where I don't know PMH and other info... I should be able to have it for any patient....


Jon

 

[DT4EMS]

Size can definately be a great help when it comes to dealing with physical confrontations. As a matter of fact, body weight means more than strength in a fight. (when a person knows how to use their body weight).

One of the neatiest things I have found about most "Big" guys 6 ft plus and over 300 is they are kind. There is a security guard that works for OMC that is HUUUUGGEE (did I say he was big?) He shows up at every seminar (course) I put on and is actually attending the one next week. The guy is a gem. Everyone loves him. I appreciate him coming becaise he is trying to learn ways to NOT hurt people. They guy could crush someone with the huge hands he has, but instead chooses to learn to be kind. If only there were more like him.

Until we get stiffer penalties for people "assaulting" EMS and ER workers, self-defense in the field is still a serious concern.

 

[Jon]

Originally posted by DT4EMS@Jul 16 2005, 09:14 PM
Until we get stiffer penalties for people "assaulting" EMS and ER workers, self-defense in the field is still a serious concern.

Yep... Security too......