Training Question: Scene Safety.

[NorCal]

So I had a scenario today, which involved two EMT students acting as the role players. Everyone on my squad had a role, mine was to interview for important medical information pertinent to the scenario, and keep the bystanders at bay so my squad could work on the patient.

Now for those of you who know, I was a Police Officer in my previous life, where scene safety is very important. In my old jurisdiction, we didn't have EMT personnel, instead we had FD personnel who were also EMT-P's.

Now with that said, the person I was interviewing during the scenario began encroaching on my squad and interfering with patient care. I asked the EMT student to back-up and give them room, and I was ignored (Repeated Twice). So I took the bystander by the arm (not a control hold or anything crazy) and I backed him up and forced him to take seat while explaining to him that he needed to concentrate on me and my questions, and let my squad work on his friend without interference.

So the EMT got upset and told me in "real life" an EMT or First Responder is never allowed to get "physical" with a patient or a bystander.

I basically told him that I disagreed, and there is a difference between a training environment and real life. (He was pissed)

When I was a cop, I used to watch the FD back people up all the time (With tact) when a bystander got in the way of patient care. The FD personnel would have us secure the scene, but more than a few times it was FD personnel who would handle individuals who impede on patient care by backing them up so their people could work.

After the scenario, I thought about it and realized that I have never been on the scene of a call with an EMT-B.

So I'm asking poising the question here. What is common practice in your neck of the woods or in your experience during medical calls where LE isn't present or delayed, and you have someone impeding on your scene and your ability to render care?

 

[jjesusfreak01]

If bystanders become disruptive and it is reasonable to do so, throw the patient in the back of the truck and continue care.

 

[LucidResq]

If bystanders become disruptive and it is reasonable to do so, throw the patient in the back of the truck and continue care.

Now now, throwing patients around is liable to get you in trouble.

I wasn't there, obviously, but it doesn't sound like you were out of line Nor.

The good thing is, from a dispatch perspective, if anything hints that there is a potential for unruly, combative or intoxicated people on scene, we always send PD. So this is not usually a huge concern. It becomes an issue when combativeness/uncooperation is unforeseen and PD is not dispatched initially. This does of course happen with some regularity. At this point getting PD on scene is usually a good idea, but in the time you are waiting, you still have to ensure everyone's safety.

If someone is compromising the safety of your coworkers and your patient and interfering with care, there is usually nothing wrong with redirecting them. Touching them at all should usually not be the first step, but it sounds like you had asked the bystander without success first. As far as taking him by the arm.... this can be a risky move. It may be necessary to keep the responders and patient safe, but it could also provoke them further. I'm sure this is obvious to you as a former LEO, but it's something to consider of course. Even if it seems successful, we live in a complaint/litigation happy society so don't forget the situation can be skewed later and bite you in the butt.

Another option is to remove the responders and patient from the danger, rather than trying to remove the danger. Sometimes, this isn't practical of course, but if this were a real life scenario and the ambulance was right there and the patient could be moved to it without harm, it would probably be a good idea.

I think the EMT classmate was wrong in saying EMS providers never "get physical" in such a broad sense. Of course, we should never be hitting or striking patients, and always use the minimum amount of force (if you can even call it that) when trying to keep things safe. There's a reason restraints are used. They shouldn't be used all the time, but they do have their place.

The FD acting in an EMS capacity is not any different really than straight EMS. You said that you've never been on scene with an EMT-B... but you have been with paramedics. When it comes to this stuff, they're really no different at all (except paramedics can administer chemical restraints in some areas). So technically you have been.

I will also tell you that in my EMT class we had a cop come in and teach us simple wrist locks and such, and how to break out of holds. Of course, you have to be EXCEEDINGLY careful with doing such things, but there are some things you can do if your safety or that of your crew is threatened. I don't think anyone expects you to lay there while being beaten to death saying "please stop hitting me sir."

 

[LucidResq]

This is a good resource for this kind of stuff from a Paramedic-turned-Cop: DT4EMS.

He used to post here as well but I haven't seen him in a while.

 

[NorCal]

Great insight, thanks.

 

[DrParasite]

I'm not going to say I have NEVER removed a disturbing person from a scene however.....

There is a BIG difference between being a duel paramedic crew and having the engine company remove an annoying person from a scene and being a two person EMT crew and one of them removing said person from a scene.

It's called strength in numbers the annoying EDP/skell/nosey neighbor probably won't mess with the cop who is removing him/her, or the 4 person engine company. However, if you are a two person crew, and one of you removes said person, and said person doesn't like being forcibly removes and takes a swing at you, or even worse, grabs whatever they can get their hands on and starts beating you over the head. Then you don't have the strength in numbers, you left your partner alone (who would need to leave the patient to help you), and you have to call for help while you defend yourself.

Remember, if you were a cop in a previous life, than you still have the training and education, but lack the tools and the legal authority to use the tools that you do still have. working as an EMT is a lot different than working a a cop