Treating suspects

[Ops Paramedic]

Is there anyone who gets to treat suspects of violent crime on a regurlar base?? It is a difficuilt one, as these patients have murdered and severly injured innocent people...

 

[MSDeltaFlt]

In regards to ground EMS: Yes, and we transport. But the law where I am states that continuity of custody must be maintained. They will remain shackled and, if the emergency arises (MVC enroute), that the pt have access to be immediately unshackled.

Translation: A cop's gotta go with.

 

[firecoins]

Translation: A cop's gotta go with.

He better come with. We aren't cops. To be in police custody requires police....obviously. I am not getting hurt trying to keep him from escaping. Nor am I equipped to do so. It would look bad for the police if I or anyone else was hurt while the suspect in custody was not under direct police supervision.

 

[Grady_emt]

Here, APD doenst have the resources to ride two deep in the cruisers, so when we transport a person in custody, the officer will follow directly behind our unit, and the perp shall be cuffed to the stretcher.

 

[KEVD18]

ma rules require that when transporting a prisoner, an officer must accompany the patient. ive had officer tell me they would follow right behind in the cruiser. no go. legally, im not allowed to monitor a patient in mechanical restraints. also, theoretically, i dont have a key on the bus so if we get into a wreck we have a problem.

now i just reread your post. were you more looking for opinions on should those accused or even possibly convicted of a crime rate the same treatment?

 

[paramedix]

Basically I would never transport a suspect, no matter what the crime, without a n officer of the law with me. He needs to be armed as well. The suspect needs to be cuffed as well.

I think the question Ops Paramedic is actually posing... do you treat suspects the same way you would treat any other patient, knowing that he/she could have killed one of you or your family members?

 

[Grady_emt]

Here, APD doenst have the resources to ride two deep in the cruisers, so when we transport a person in custody, the officer will follow directly behind our unit, and the perp shall be cuffed to the stretcher.

Well here in Atlanta we do have a city, county and United States Penitentiary: Atlanta. "Club Fed" as we call it is a Medium security federal prison. Its not unusual for a Pen call to last two hours+ as depending on the level of the inmate determines the number of guards that go with him and have to be rounded up. Last night we went and transported a High-Risk inmate. We had eight guards total, Two in the front van with MP5 looking guns, Two in the rear van also with MP5s, Two in the back of the truck with their sidearms, and one riding in our cab with a shotgun. There was also one other gurard that left before we did to scout the route. Due to his high risk factor they did not tell us where we were transporting to, only that we just needed to "follow the Blues on the first truck" (the P.A. had already called the recieving hosp to give a report so we were just providing the ride)

During the day at the Pen, there is and MD on site and has a fully equipped office with EKG, basic labs, Xray, etc. At night there is an P.A. who runs the joint and is really good about only calling 911 when it is something that cannot be handled inhouse or wait until morning.

 

[LucidResq]

Yeah I'm more interested in the emotional side of this rather than the logistics.

I realize that all people are to receive the same standard of care, but how do you cope with taking care of someone who, for example, beat the crap out of their toddler and broke their hand doing it or something?

 

[johnrsemt]

prisoners

I work for a private service that does alot of prisoner transfers: go to small hospital, get prisoner take them to level I trauma center with lock down units all over it.

Alot of our medics wont transfer pt till they know what he is in for: (guard goes with us in back with keys, and 2nd follows, armed).

I don't want to know what they did: I hope that I never hit the point that it would make a difference in my treatment of pt or medical condition. We do have medics that don't treat pt, they just transport them. had one that let a pt seize for 73 miles without treating it. another that did nothing for chest pain with known acute MI.

I hope if I ever get to that point that I stop working EMS. I want to treat the patient and their issues, not what they did. Same when I am working 911.

 

[Grady_emt]

Yeah I'm more interested in the emotional side of this rather than the logistics.

I realize that all people are to receive the same standard of care, but how do you cope with taking care of someone who, for example, beat the crap out of their toddler and broke their hand doing it or something?

First priority is the kid, and then the adult. I guess I've seen the above situation nearly verbatum (sp), and once we had the kid transported by another unit, we treated the father and let PD transport him. It makes for a long night, but talking with someone who understands what you are going through is the key be it your partner, supervisor, a journal, etc.

While you may not go out of your way to make conversation with that patient, or give them a pillow, you are still obligated to provide that patient with the same care that you would provide to any other person. It just makes that hug and kiss you get before you leave the house, when you get home and that one that wakes you up on Saturday mornings even more meaningful.

 

[Ops Paramedic]

Tahnks for the replies!! I think that Lucid got the point i was trying get across. How can you treat a suspect (of the side of the road), when all that ou are is telling you not to?? Bearing in mind, that it might have been your family or friends that was threatend with their lives at gunpoint, or even suspect that dicharged/fired (Contrary to popular belief, there is no such thing as friendly fire, when you fire a weapon, it is intended to do harm) a weapon at law enforcement, the people who has your back when the situation get roudy??

This can be an ethical issue with possible legal complications for the pratitioners. Once again today i had two red code suspects who had robbed, hijacked, and where on their way to rob again. Fortunately for them, the shooter's aim was a bit out...

 

[VentMedic]

Yeah I'm more interested in the emotional side of this rather than the logistics.

I realize that all people are to receive the same standard of care, but how do you cope with taking care of someone who, for example, beat the crap out of their toddler and broke their hand doing it or something?

For cases where the person has not been charged yet and you are the only one suspecting abuse, you must be careful with your emotions and reactions. Many child abuse cases are not always blatantly obvious but just as bad. The best you can do is keep your feelings in check until you can get the child to the hospital and their staff can get the child into protective custody. You may have to pretend to believe everything the parent says about the child falling or whatever just to get the the child to safety and let LEOs handle the rest.

It may actually take several days to months to adequately build a case against people who abuse their children and S.O.s. How you act and/or react in these situations can potentially make or break some cases. A cool professional head with focus on the patient is best.

If the patient happens to be the person suspected of a hideous crime, again, a cool professional head is required to treat fairly and not give a savvy attorney ammunition to distract from the case as a technicality.

Find an outlet for your feelings by talking to someone close to you but not necessarily a family member. A chaplain or senior member of your ambulance service may be good to express your feelings to.

Don't take your work home with you. I have had a ritual of changing my uniform back to regular clothes from the day I started in the medical profession 30 years ago. It started because the company laundered our uniforms but I found I always felt better leaving them behind. Later, I did it because of infection control and not taking "my work" home to the family in the form of bacteria and viruses. I still feel good get out of my work clothes even though I enjoy wearing them on the job. Granted, many memories can't be shrugged off by just changing clothes but I have a life to think about away from work that is just as or more important. I don't want to mess that up by doing or saying something stupid to someone who has yet to go through the legal/court system. Occasionally I would like to believe our justice system works. If it is an inmate who is already incarcerated needing medical attention, I can then believe their life is now in the hands of the prison system for their due justice and punishment. I provide the necessary medical care and let the system do the rest.

 

[firetender]

When you're in the midst of the scene it needs to be all about the work.

During ANY call you can let yourself be carried away by who you think the person is or what you believe they did. If you're not careful, the attitude that YOU are manufacturing can negatively impact the care you give your patient. After all, you REALLY don't know for sure at the time what's true, it usually just lives in your head!

So, just like any other distraction, if it gets in the way of rendering good patient care, toss it.

 

[Jon]

I've worked security for 3+ years, and I'm certified to carry/use handcuffs for THAT job.

When I'm on the ambulance... I'm just an EMT. If I take a patient who is in custody, from a police station, I REALLY try to have an officer in the rig with me. Almost all of our local PD's only ride 1 man per car... so it isn't really an option to have someone ride in with me... the officer usually follows on my rear bumper. I've only ever had 1 problem with this, and it was a transfer from the prison. We had a C.O. in the rig with us, but the C.O.'s Corporal who was following us was apparently the only one allowed to have the keys... and he got separated during the ride to the ED.

I've had some patients in custody where, given the totality of the circumstances, it was better not having the LEO in the rig.... One example is the dumba** drunk that was spitting, biting, and kicking at the PD and it was a vicious cycle... he'd attack an officer, get "restrained" and then attack again... Once I explained that, if he was nice, I'd take him to the hospital... he decided to go with me, and the friendly LEO followed me. (This was not a slam on the LEO's... they seemed justified in what they were doing... and I LOVE all LEO's!). I'm willing to take the risk and transfer some patients in restraints without an officer with me, because, if push comes to shove, I can remove the cuffs. This is a judgment call on MY part, and only happens if the officer is following me.


Now, if we were transporting someone who was suspected of something more serious (like an attempted murder/suicide)... there'd be a LEO in the rig with the patient... and the LEO would probably go on the helicopter ride if the patient was stable enough to go to a T.C. If they had to leave a car onscene... well... they're going to be on scene for a while anyway, right?

 

[firecoins]

To the people with PD departments with one cop per car. Most local police are like this. I still get a cop inside. He can get his car picked up later. A 2nd cop will follow in his car. The suspect must be in police custody to be in cuffs. Or no cuffs and he gets taken into custody at the ER. Either he is in police custody or he isn't.

Prisoner transfers from our local prison always get a correctional officer in the bus and one corrcetional officer following in a correctional vehicle . These are the rules of the prison and done without exception.

About what the suspect is suspected of doing, I don't care what the patient is in for. This has no bearing on anything. Child abuse, rape, murder we treat any way. No need for me to know unless it affects my safety or that my crew.

 

[MedicPrincess]

The prison in our county houses federal prisoners. These guys are some of the worst offenders. I recently transported a prisoner and at first I didn't quite understand why they CO's wanted 3 in the back, 1 in the front, and 2 following. Seemed a bit like overkill. But I just figured they have their reasons for this one...normally we get 1 in front, 1 in back, 2 following.

On the way to the hospital the pt started telling me about his crimes. All total 9 murders, 4 attempts on law enforcement, multiple escape attempts....in 3 states.

In this case, it was a 35 minute transport time. A lot can happen in 35 minutes. The way I figure it, there are two options. I can be ugly, short, and let them know how I feel about what they have done. Or I can treat them like people too and give them the best care I can. One way gets us to the hospital with a calm and cooperative pt, the other potentially gets my tail kicked.

In this patients case, he actually thanked me for being kind to him on the trip.

had one that let a pt seize for 73 miles without treating it. another that did nothing for chest pain with known acute MI.

This medic ought to have some sort of disiplinary action. I am sure your protocols, as well as your state statues, don't have a provision for negligence because the patient is convicted of something the provider disagrees with.

 

[Jayxbird521]

i do i work and coatesville and half the time i think its becase the think they will get out of trouble if they go to the hospital ha beleve me if i think thats the reason why they would wish they would have gone to jail

 

[ffemt8978]

i do i work and coatesville and half the time i think its becase the think they will get out of trouble if they go to the hospital ha beleve me if i think thats the reason why they would wish they would have gone to jail

WTF?!? :sad:

It is not up to you to decide if the patient is faking something to get out of going to jail, and it sure as hell isn't up to you to make them regret their decision. Around here, actions like that will result in YOU getting arrested and charged.

Explain to me how your attitude is in any way related to being an advocate for your patient. After all, we're here for the patient, correct?

Seek help...seek professional help and soon, before you end up killing somebody because you thought they were trying to get out of going to jail.