Suicide Calls

[Wingnut]

I got to thinking again (I know dangerous, but it happens). We had 4 suicide/attempted yesterday in about 2 hrs time. And more this month alone than we've had all year. So we were chatting about it and our chopper pilot (I was riding at our medflight station yesterday...on a rig though) told us that a few years back they picked one up and he jumped out of the helo after they got pretty high up and managed to succeed the second time. SO there's a rule now that medflight no longer picks up attempted suicide calls.

Do you have any "wierd" rules for them too? It's seems common sense but I know I don't usually think of the pt trying to off themselves while they're with us.

*With such limited space I don't know how he managed it, and I didn't think to ask but he did it. AND our copters have a 3 man crew on them.

 

[DT4EMS]

I can't speak much about inside of a helicopter, but I can tell you about the inside of an ambulance.

Since the push for de-institutionalism of mental patients, we in EMS are more often than not their first exposure to medical care.

With this comes the major safety issue for EMS Providers in the field. The moment you recognize you are dealing with an EDP (Emotionally Disturbed Person) your safety becomes the FIRST priority.

Rules:

Most important...listen to your gut instinct. Call for LEO when possible (if not already dispatched). Even if you don't need them, it is better to have them en route.

You and your partner need to be on the same page.

Distance (try to maintain a safe distance) Distance varies depending upon the situation. Obtaining a BP from a non-cooperative/potentailly aggressive person is not a major concern. Ask, but if they don't want to allow you, don't force the issue.

Verbal Skills- Talking to them can help give you a sense of their mindset. Talk slow and be direct. Do more listening than talking if possible.

Angles- Always stand at a slight angle. Careful not to appear aggressive. When transporting, sit either in the Captain's Chair or angled high enough on the bench seat to "Buy a second" if things go south.

Since human interaction/conflict is dynamic, there is no absolute hard and fast rule for every situation. Instead the basics must always be there.

 

[Chimpie]

Good advice.

 

[HFD EMS]

Last weekend in one night within my 12 hour shift....we had 3 suicide attempt calls...the first one had ran out in front of a car and had a panic attack...luckly the car barely hit the pt....then we were dispatched out to a guy who had covered himself in gas and threaten to light himself on fire and then the last call was to a person that threaten to overdose on her heart medication. I live in a smaller county and this is highly unusual but we found that these people are highly unpredictable and can be extremely dangerous. The best piece of advice to give you from my experience is definitely keep your distance cuz they will latch onto you if you get to close. They will try to grab you for i quess moral support and you may feel the need to help them but i would highly advise you to keep your distance from them and try to talk them down and have an LEO deal with the situation because the pt might freak out on you and without proper defense you may have a worse situation on your hands.

 

[Raf]

That's interesting that you mention standing at an angle. I think that's a very effective way to show them that you are not going to act aggressive towards them.

 

[DT4EMS]

That's interesting that you mention standing at an angle. I think that's a very effective way to show them that you are not going to act aggressive towards them.

In DT4EMS classes we teach an "L" or "V" configuration. Think of the "unknown" type patient standing at the point of either letter. You and your partner are at the other angles.

This way if a person wants to attack, they have to "Make a Decision" on who and how to attack. It can "Buy you a second" to escape if the need be.

We always say not being on an unsafe scene in the first place is the best defense, but the truth is more medics are hurt on supposed Safe Scenes.

 

[FFEMT1764]

I have noticed in my 13 years of EMS that the number of psych calls you have is directly related to the phase of the moon, ie, full moon = lots of psychs. We are allowed to fly suicidal people here if they have shot/stabbed/traumaed themselves because we only have a dinky little county hospital, the flight crews will however RSI any patient that is or could become combative before we even leave the truck. Most paralyzied people tend to remain in the helicopter for the duration of the flight. As far as the non critical attemptees we usually strap them down or if need be we restrain them with cravats and use our wonderous 9' straps to help keep them at bay until the ER can give them some Geodon!

 

[MedicPrincess]

Most paralyzied people tend to remain in the helicopter for the duration of the flight.

So....it begs to question...if only "MOST" of your paralyzed patients are remaining in the helo for the duration flight....what happens to the rest? One of your paralyzed patients get a little nasty look in their eye and out they had to go??? hmm...