Using force to defend yourself.

[medic417]

These threads are always so much fun to read.

LOL you got that right. My first reply should have been the end of this discussion.

 

[DT4EMS]

Using a nrb mask to prevent spitting is actually in our protocols. Obviously you have to hook it up to oxygen 15 lpm to do this or if you didnt it would be the equivalent of putting a plastic bag over someones head..

I have only had to do this two times. And it was for a person that 5 cops could hardly keep down because he was the size of Paul Bunyan.. Plus the guy had hepititis a,b,c,d,e,f,g, aids, and every other disease..and was spitting blood all over the place. I have actually had ppatients handcuffed and put the pt face down, but a leo has rode with in the back.

What is the lawyer going to be more mad about, me restraining a person with the best thing I can use in the ambulance or seeing a medic getting his a$$ kicked in the back of the ambulance.. If they dont like creative ways of restraining people that is still safe (checking breathing, pms) then they need to give us handcuffs and tasers. Because a junky little soft restraint doesnt always do the trick...we arent always tying down a 90 pound 90 year old woman who is postictal.

Please don't think I am not on your side.........because I am. The issues I have are with administrations failing to provide training for the people who actually do the job.


I am glad you clarified turning on the O2......... sometimes people new in the field of EMS read something posted in a forum and take it as gospel.......without realizing the OP meant well but left a line out.

Simple........... A PPE face mask makes a perfect spittle protector........ then there is no need for the NRB or the O2. Plus that mask is DESIGNED to prevent the transmission of diseases. I will gladly debate it with your medical director to help your agency out.

LEO agencies across the country are training to get people off of their stomachs as soon as possible. Leaving a restrained person in the prone position is really bad ju-ju........they die....

Again the issue is simple.......our street level EMS providers across the country face daily split-second decisions that must be made. Most of the training is on-the-job for the assault and restraint type topics.

Talk to a few people that have lost a job or faced criminal prosecution for using force that was not considered reasonable.

I am here to help........not hack you off. I truly hope you take the same stance with your safety at the workplace.

Kip

 

[tazman7]

Aint it fun? Had a narc OD last winter that we used Narcan on. I was just out of ILS class and my Intermediate partner was doing pt care. So while I am bagging the guy she draws up 6mg of Narcan and attaches to the dripset. I assumed she was going to push 2, maybe 2.5 and the check resps. Well, she starts, I watch her push about 1 or 1.5, I look over at the monitor to check SPO2 and rhythm and by the time I look back she is just finishing pusing all 6 mg! AHHHH!!! The last thing I thought before he woke up was "This is about to get really bad........" In 10 seconds he went from dead to fighting like a maniac. He picked my partner up (And she is not a featherweight) and threw her about 3 feet onto a couch. We had two cops on scene with us, one county deputy, us two Intermediates and one firefighter Basic. It took the two cops, the firefighter and I to hold this guy while the deputy cuffed him. One cop had him in a headlock, the basic was holding one arm in a winglock I had his other arm and the other cop had his legs. If he had come at me though he would have got a fist to the jaw and a knee to the groin.

In my experience I have found that if you use the MAD device instead of an iv, not only does it limit your exposure to "goo" it seems that they dont come out of their high as mad...

I work in a town where I have given more Narcan than Normal Saline....(not kidding either)

Here is how my partner and I typically run an overdose, so take it for whats its worth. considering the pt is unconscious with slow respirations. We will bag the pt if needed or a nrb mask. Put pt on a backboard with spider straps if they are known for getting violent. If not just use the backboard straps. Give pt 2mg narcan through the MAD device up the nose. Put pt on cot and into ambulance. Take some vitals and by that time the pt is usually starting to regain consciousness.. then obviously cardiac monitor, iv- if needed and they wont tear it out...

Doing it this was in my experience seems to result in them not being as mad as a hornet when they realize you ruined their high..

Before the MAD device was put in service they seemed to get a lot more angry giving it to them through the iv, plus they would rip the iv out and blood would fling everywhere... As far as im concerned its my safety before the patient. So doing it this way eliminates blood exposure to myself and my partner.

 

[tazman7]

Please don't think I am not on your side.........because I am. The issues I have are with administrations failing to provide training for the people who actually do the job.


I am glad you clarified turning on the O2......... sometimes people new in the field of EMS read something posted in a forum and take it as gospel.......without realizing the OP meant well but left a line out.

Simple........... A PPE face mask makes a perfect spittle protector........ then there is no need for the NRB or the O2. Plus that mask is DESIGNED to prevent the transmission of diseases. I will gladly debate it with your medical director to help your agency out.

LEO agencies across the country are training to get people off of their stomachs as soon as possible. Leaving a restrained person in the prone position is really bad ju-ju........they die....

Again the issue is simple.......our street level EMS providers across the country face daily split-second decisions that must be made. Most of the training is on-the-job for the assault and restraint type topics.

Talk to a few people that have lost a job or faced criminal prosecution for using force that was not considered reasonable.

I am here to help........not hack you off. I truly hope you take the same stance with your safety at the workplace.

Kip

Yeah I sometimes have to control my anger with some of these idiots and so far so good. But I refuse to let a pt hit/spit/kick/push me.

Ill see if I can dig up one of those masks to try the next time...I think I seen one at the back of our airway cabinet with a bunch of dust on it.

 

[DT4EMS]

Yeah I sometimes have to control my anger with some of these idiots and so far so good. But I refuse to let a pt hit/spit/kick/push me.

Ill see if I can dig up one of those masks to try the next time...I think I seen one at the back of our airway cabinet with a bunch of dust on it.

I am 100% all for EMS providers being able to defend themselves...........heck it is what I have been teaching for 14 years...... but there is more to it than just the physical skills.

EMS self-defense is unique......first of all.......the general public has no idea the rates of EMS assault (30x that of other private sector jobs)

Then hospitals want to have the perception of being like a "hotel"
so unless a person is shot or stabbed inside the ER......it rarely makes the news.

Now........ in training for EMS self-defense....or better put Defensive Tactics for EMS (because tactics are way more important than any technique) the provider needs to train four specific areas"

1) Mind- by learning what is OK and what is not acceptable the provider can make better decisions about force. Plus they can get past the "it's part of the job" mentality that has plagued EMS

2) Street- the actual physical self defense skills must work "more often than not" and be easy to learn and retain.

3) Media- Must be trained so that all skills; including verbal, body language and actual physical skills appear to be in self-defense.....not a fight..........because EVERYONE loves to post stuff on YouTube.

4) Courtroom- Force is judged by relationship. Was it reasonable? So every tactic/technique has it's place on the reasonable scale.

Any anecdotal stories in the station of how a provider did this or that to protect themselves may not always be the best course of action. If the provider isn't covered in all "4" areas.....they could be without a job or worse.

This is what I do......... I get calls from EMS agencies around the country telling me their nightmare stories of providers allegedly defending themselves. It's funny how when liability sets in.........how quickly agencies wish to "separate" themselves from the employee.

 

[tazman7]

I am 100% all for EMS providers being able to defend themselves...........heck it is what I have been teaching for 14 years...... but there is more to it than just the physical skills.

EMS self-defense is unique......first of all.......the general public has no idea the rates of EMS assault (30x that of other private sector jobs)

Then hospitals want to have the perception of being like a "hotel"
so unless a person is shot or stabbed inside the ER......it rarely makes the news.

Now........ in training for EMS self-defense....or better put Defensive Tactics for EMS (because tactics are way more important than any technique) the provider needs to train four specific areas"

1) Mind- by learning what is OK and what is not acceptable the provider can make better decisions about force. Plus they can get past the "it's part of the job" mentality that has plagued EMS

2) Street- the actual physical self defense skills must work "more often than not" and be easy to learn and retain.

3) Media- Must be trained so that all skills; including verbal, body language and actual physical skills appear to be in self-defense.....not a fight..........because EVERYONE loves to post stuff on YouTube.

4) Courtroom- Force is judged by relationship. Was it reasonable? So every tactic/technique has it's place on the reasonable scale.

Any anecdotal stories in the station of how a provider did this or that to protect themselves may not always be the best course of action. If the provider isn't covered in all "4" areas.....they could be without a job or worse.

This is what I do......... I get calls from EMS agencies around the country telling me their nightmare stories of providers allegedly defending themselves. It's funny how when liability sets in.........how quickly agencies wish to "separate" themselves from the employee.

This is very true. Restraining people is a very touchy topic. That is why you should only doing when possible..... almost all of the time I just call LE- but sometimes I have to handle it myself.

 

[medic417]

It's funny how when liability sets in.........how quickly agencies wish to "separate" themselves from the employee.

LOL. You are correct on that. Another reason to carry your own liability and malpractice insurance that covers your own attorney. The employers attorney does not always have your best interests at heart.

 

[FLEMTP]

easy way to answer this for those of us who work and/or live in the state of Florida... and this applies to ALL people in Florida.. including EMS... on duty or off duty. Also battery of a EMS worker is a felony in the state of Florida... just in case you were wondering.

776.012 Use of force in defense of person.--A person is justified in using force, except deadly force, against another when and to the extent that the person reasonably believes that such conduct is necessary to defend himself or herself or another against the other's imminent use of unlawful force. However, a person is justified in the use of deadly force and does not have a duty to retreat if:

(1) He or she reasonably believes that such force is necessary to prevent imminent death or great bodily harm to himself or herself or another or to prevent the imminent commission of a forcible felony; or

(2) Under those circumstances permitted pursuant to s. 776.013.



776.013 Home protection; use of deadly force; presumption of fear of death or great bodily harm.--

(1) A person is presumed to have held a reasonable fear of imminent peril of death or great bodily harm to himself or herself or another when using defensive force that is intended or likely to cause death or great bodily harm to another if:

(a) The person against whom the defensive force was used was in the process of unlawfully and forcefully entering, or had unlawfully and forcibly entered, a dwelling, residence, or occupied vehicle, or if that person had removed or was attempting to remove another against that person's will from the dwelling, residence, or occupied vehicle; and

(b) The person who uses defensive force knew or had reason to believe that an unlawful and forcible entry or unlawful and forcible act was occurring or had occurred.

(2) The presumption set forth in subsection (1) does not apply if:

(a) The person against whom the defensive force is used has the right to be in or is a lawful resident of the dwelling, residence, or vehicle, such as an owner, lessee, or titleholder, and there is not an injunction for protection from domestic violence or a written pretrial supervision order of no contact against that person; or

(b) The person or persons sought to be removed is a child or grandchild, or is otherwise in the lawful custody or under the lawful guardianship of, the person against whom the defensive force is used; or

(c) The person who uses defensive force is engaged in an unlawful activity or is using the dwelling, residence, or occupied vehicle to further an unlawful activity; or

(d) The person against whom the defensive force is used is a law enforcement officer, as defined in s. 943.10(14), who enters or attempts to enter a dwelling, residence, or vehicle in the performance of his or her official duties and the officer identified himself or herself in accordance with any applicable law or the person using force knew or reasonably should have known that the person entering or attempting to enter was a law enforcement officer.

(3) A person who is not engaged in an unlawful activity and who is attacked in any other place where he or she has a right to be has no duty to retreat and has the right to stand his or her ground and meet force with force, including deadly force if he or she reasonably believes it is necessary to do so to prevent death or great bodily harm to himself or herself or another or to prevent the commission of a forcible felony.

(4) A person who unlawfully and by force enters or attempts to enter a person's dwelling, residence, or occupied vehicle is presumed to be doing so with the intent to commit an unlawful act involving force or violence.

(5) As used in this section, the term:

(a) "Dwelling" means a building or conveyance of any kind, including any attached porch, whether the building or conveyance is temporary or permanent, mobile or immobile, which has a roof over it, including a tent, and is designed to be occupied by people lodging therein at night.

(b) "Residence" means a dwelling in which a person resides either temporarily or permanently or is visiting as an invited guest.

(c) "Vehicle" means a conveyance of any kind, whether or not motorized, which is designed to transport people or property.






776.031 Use of force in defense of others.--A person is justified in the use of force, except deadly force, against another when and to the extent that the person reasonably believes that such conduct is necessary to prevent or terminate the other's trespass on, or other tortious or criminal interference with, either real property other than a dwelling or personal property, lawfully in his or her possession or in the possession of another who is a member of his or her immediate family or household or of a person whose property he or she has a legal duty to protect. However, the person is justified in the use of deadly force only if he or she reasonably believes that such force is necessary to prevent the imminent commission of a forcible felony. A person does not have a duty to retreat if the person is in a place where he or she has a right to be.



776.032 Immunity from criminal prosecution and civil action for justifiable use of force.--

(1) A person who uses force as permitted in s. 776.012, s. 776.013, or s. 776.031 is justified in using such force and is immune from criminal prosecution and civil action for the use of such force, unless the person against whom force was used is a law enforcement officer, as defined in s. 943.10(14), who was acting in the performance of his or her official duties and the officer identified himself or herself in accordance with any applicable law or the person using force knew or reasonably should have known that the person was a law enforcement officer. As used in this subsection, the term "criminal prosecution" includes arresting, detaining in custody, and charging or prosecuting the defendant.

(2) A law enforcement agency may use standard procedures for investigating the use of force as described in subsection (1), but the agency may not arrest the person for using force unless it determines that there is probable cause that the force that was used was unlawful.

(3) The court shall award reasonable attorney's fees, court costs, compensation for loss of income, and all expenses incurred by the defendant in defense of any civil action brought by a plaintiff if the court finds that the defendant is immune from prosecution as provided in subsection (1).

 

[usafmedic45]

I teach the "Diabetic" is one of our "6 D's", the calls with the potentiall for violence.

So....
1. Diabetic
2. Drunk
3. Drugs
4. Delirious/demented
5. DTs
6. Uh.....dumbass? Dog tattoo?
I would think "damaged" might be a good fit for the mnemonic to indicate the prevelance of combative behavior after head trauma.

Restraining people is a very touchy topic.

Yeah, healthcare became a much less pleasant job when it became a bad thing to chemically or physically restrain uncooperative/unpleasant/combative/demented patients.

 

[CAOX3]

Hows that old saying go. "Its better to be judged by twelve then carried by six"

Ill deal with a courtroom later if it comes up, but I will do anything whithin my power to assure we go home at night.

I always tend to lean more towards waiting or calling for the police if something doesnt feel right. Yeah sometimes they get pissed off but hey they get over it.

I agree I think EMS as a whole is completely unprepared for violent confrontations that may occur.

 

[DrParasite]

Hows that old saying go. "Its better to be judged by twelve then carried by six"

Ill deal with a courtroom later if it comes up, but I will do anything whithin my power to assure we go home at night.

I always tend to lean more towards waiting or calling for the police if something doesnt feel right. Yeah sometimes they get pissed off but hey they get over it.

I agree I think EMS as a whole is completely unprepared for violent confrontations that may occur.

I was wondering when someone was going to say this.

You should only use as much force as is necessary to mitigate the threat. that being said, if I find myself where I am faced with a threat to my life or health, I am going to use whatever force is necessary to make sure I go home at the end of the night.

That doesn't mean I beat the crap out of a EDP or drunk until he stops breathing just because he is pissing me off. but if i need to use force until he stops moving, or until additional help arrives, or until I can get myself to safety, then I am going to do what I need to in order to stay alive, and I will deal with the consequences later.

As the old saying goes: "Its better to be judged by twelve then carried by six"

 

[Melclin]

The agitated patient

Pt does not respond to verbal de-escalation techniques.
Clinical causes have been excluded (hypoxia, hypoglyc etc)

Basic: 0.1mg/kg IM Midazolam, ten minutely, max 4 doses, half doses for systolic BP<100 or age >60.

Intensive Care: 0.1mg/kg IV, 5 minutely, as needed.


I'm of the opinion that with the hypo patient, without any Water Fairies or? Jacks present, if you can get close enough to safely administer Midaz/Diaz/Haloperidol, then you should probably be giving them Glucagon and standing back, if they're seriously off their tree, its one for the Jacks.

 

[DT4EMS]

I was wondering when someone was going to say this.

You should only use as much force as is necessary to mitigate the threat. that being said, if I find myself where I am faced with a threat to my life or health, I am going to use whatever force is necessary to make sure I go home at the end of the night.

That doesn't mean I beat the crap out of a EDP or drunk until he stops breathing just because he is pissing me off. but if i need to use force until he stops moving, or until additional help arrives, or until I can get myself to safety, then I am going to do what I need to in order to stay alive, and I will deal with the consequences later.

As the old saying goes: "Its better to be judged by twelve then carried by six"

Like the medic in Denver?

 

[DT4EMS]

Hows that old saying go. "Its better to be judged by twelve then carried by six"

Ill deal with a courtroom later if it comes up, but I will do anything whithin my power to assure we go home at night.

I always tend to lean more towards waiting or calling for the police if something doesnt feel right. Yeah sometimes they get pissed off but hey they get over it.

I agree I think EMS as a whole is completely unprepared for violent confrontations that may occur.

Unprepared because many believe that preparing for defending oneself in EMS means smashing them with the O2 bottle or "doing whatever it takes" and "I'll worry about the court later type of mentality" without training.

The former medic in Denver.............who is now serving 12 years in prison..........for having that same mentality. Smashing a guys face..........when REASONABLE is a good deal. Those that sit and talk about how they will handle the court later must realize you can PREPARE for the court before you ever go.

Why is it you think that personal protection must not be liability conscious? You think you either have to cream the attacker OR be legally defensible............

It is this failure to prepare mentality that is keeping EMS in more of harms way. You don't have to agree with me........ just look at the facts.

If it is not an issue, why have the NAEMT, CDC, OSHA and others completed studies on the assaults facing EMS and healthcare?

If Dr. Brian Maguire (UMBC) found EMS is assaulted at a reate 30X that of other private sector jobs......... why is it wrong for people to train?

Recognition, Prevention and ESCAPE training is different than training to be a combatant.

 

[ZVNEMT]

I've been pretty lucky so far and not had to defend myself. though i realize now that I've left myself pretty open to assault on at least one occasion where a drunk (not a pt, didn't flag us down or even speak to us) jumped into the back of my ambulance while we were posted. I jumped out, grabbed the collar of his jacket and dragged him out, yelled "what the hell are you doing?!"... after a couple seconds i relaxed a bit and asked him what he needed, he wanted a ride home, we called a cab for him. Now i realize things could have gone catastrophically wrong, putting myself and my partner in danger. really the whole situation could have been avoided had we locked the ambulance... but I never thought about locking it while in it...

 

[DT4EMS]

I've been pretty lucky so far and not had to defend myself. though i realize now that I've left myself pretty open to assault on at least one occasion where a drunk (not a pt, didn't flag us down or even speak to us) jumped into the back of my ambulance while we were posted. I jumped out, grabbed the collar of his jacket and dragged him out, yelled "what the hell are you doing?!"... after a couple seconds i relaxed a bit and asked him what he needed, he wanted a ride home, we called a cab for him. Now i realize things could have gone catastrophically wrong, putting myself and my partner in danger. really the whole situation could have been avoided had we locked the ambulance... but I never thought about locking it while in it...

We ask agencies make it a policy doors be locked at all times just for the very reason you mentioned. The interesting point you made with your post is "perception". At the time of your incident, you did not preceive a threat of bodily harm to you or your partner. The force you used would be considered reasonable even though the guy never touched you.

It is interesting how a situation that made you think has probably changed your behavior. It essentially trained your brain. Good job!

 

[DT4EMS]

I have had more than one administrator make comments just like some of those previous ones posted………until they attended one of my courses. Now they have made our training mandatory for all staff.

I have presented at many local, state and even national conferences and have had people with 20 years plus experiences in EMS have a paradigm shift about this subject. Not every assault is a battle of life and death….. Safety tactics can help a provider prevent an assault from taking place.

For instance…….. Where do you stand when you knock on a door?
Did you know your normal patient assessment positioning can be used as a self-defense tactic? We call it the “Assessment L”.

If everyone stages for an unsafe scene……. Why are assaults the number one cause for lost work hours in EMS?

How do you define “uncooperative patient” vs. “attacker”? Do you respond differently to them?

Do you know how to properly document an incident if attacked? What if you used force to defend yourself?

If a police report is filed after an EMS provider is assaulted, does it make it more difficult for the attacker to win a civil suit? Can that same paperwork remove the “machismo” appearance of the EMS provider?

My credentials have made me subject matter expert in the field of self-defense for EMS and why EMS should be training for it. What makes you an expert on why EMS should not train?

 

[MonkeySquasher]

Using a nrb mask to prevent spitting is actually in our protocols. Obviously you have to hook it up to oxygen 15 lpm to do this or if you didnt it would be the equivalent of putting a plastic bag over someones head..

I have actually had patients handcuffed and put the pt face down, but a leo has rode with in the back.

A.) Surgical mask. NRB are made for O2 administration. N95 is made to not allow droplets -IN-, and can kind of hamper breathing. Surgical mask is paper-thin for a reason - When you just need a little, breathable barrier and stop spitting. And no one will fault you for having it. Also good for ill coughing patients..

B.) Nooo, no no no. There is no reason to ever transport someone face-down and restrained. I have flat out refused to do it, and made LEO cuff their hands to the stretcher frame on either side. This forces one officer to ride, and another to follow, and my patient survives, and I follow my protocols. Everyone's happy.

You can be polite about it, and most cops will be okay with it. "Hey, my rules/protocols say they have to be face-up and cuffed in front.", and most cops will oblige. The only time the guy ever questioned me, I called my supervisor, who basically told him if he didn't feel like doing it, he can hand his collar over to someone else or transport the bleeding guy himself. haha

For instance…….. Where do you stand when you knock on a door?
Did you know your normal patient assessment positioning can be used as a self-defense tactic? We call it the “Assessment L”.

If everyone stages for an unsafe scene……. Why are assaults the number one cause for lost work hours in EMS?

How do you define “uncooperative patient” vs. “attacker”? Do you respond differently to them?

Do you know how to properly document an incident if attacked? What if you used force to defend yourself?

I know the first parts, but that's also because I've had training outside of EMS for personal protection. But you're right, that kind of stuff should be taught more. Our BLS/ALS classes spend about 1 hour/1 night (respectively) covering it.

Unfortunately, people DONT stage when they should. Just because "the assailant is gone" doesn't mean they didn't go to grab a bigger gun and come back. Just because a police car has pulled up doesn't mean the scene is safe. And just because he's "just a crazy old man" or "just a drunk" doesn't mean he won't turn violent.

Also, are you sure on those figures? I'd think that back injuries lead to more lost work hours than assaults... Just my thought.

As for the definition... An "uncooperative patient" usually has an altered mental status. Your diabetics, ETOHs, semi-responsive patients, electrolye imbalances, even in some cases your psychiatrics.. Suicidal people, agitated people, etc. They don't MEAN to hurt you, they aren't in their right state of mind. In my definition, an "attacker" is someone who WILLFULLY seeks to cause harm to an EMS worker, while in a proper frame of mind. That's not to excuse someone who has schizophrenia or something who walks into a McDonalds and stabs an 18-year old girl in the chest.. That's an attacker. But the semi-conscious drunk kid who hit me last year because the nurse attempted an IV when I let go to do something, that's just an unfortunate incident. For the AMS, I just talk to them and attempt to gently restrain them or keep them from causing harm to themselves or others. Also includes putting "gloves" on them... A towel wrapped around their hands with immobilization tape around it. For the actual attacker, they are no longer a patient, they're an aggressor, which means using any and all means to defend myself to the extent possible to escape the situation.

Unfortunately, in the law, the "attacker" would be anyone who causes the harm, no matter the cause. Then they'd have to prove a medical condition as the proximate cause as a defense.

 

[DT4EMS]

A.) Surgical mask. NRB are made for O2 administration. N95 is made to not allow droplets -IN-, and can kind of hamper breathing. Surgical mask is paper-thin for a reason - When you just need a little, breathable barrier and stop spitting. And no one will fault you for having it. Also good for ill coughing patients..

B.) Nooo, no no no. There is no reason to ever transport someone face-down and restrained. I have flat out refused to do it, and made LEO cuff their hands to the stretcher frame on either side. This forces one officer to ride, and another to follow, and my patient survives, and I follow my protocols. Everyone's happy.

You can be polite about it, and most cops will be okay with it. "Hey, my rules/protocols say they have to be face-up and cuffed in front.", and most cops will oblige. The only time the guy ever questioned me, I called my supervisor, who basically told him if he didn't feel like doing it, he can hand his collar over to someone else or transport the bleeding guy himself. haha





I know the first parts, but that's also because I've had training outside of EMS for personal protection. But you're right, that kind of stuff should be taught more. Our BLS/ALS classes spend about 1 hour/1 night (respectively) covering it.

Unfortunately, people DONT stage when they should. Just because "the assailant is gone" doesn't mean they didn't go to grab a bigger gun and come back. Just because a police car has pulled up doesn't mean the scene is safe. And just because he's "just a crazy old man" or "just a drunk" doesn't mean he won't turn violent.

Also, are you sure on those figures? I'd think that back injuries lead to more lost work hours than assaults... Just my thought.

As for the definition... An "uncooperative patient" usually has an altered mental status. Your diabetics, ETOHs, semi-responsive patients, electrolye imbalances, even in some cases your psychiatrics.. Suicidal people, agitated people, etc. They don't MEAN to hurt you, they aren't in their right state of mind. In my definition, an "attacker" is someone who WILLFULLY seeks to cause harm to an EMS worker, while in a proper frame of mind. That's not to excuse someone who has schizophrenia or something who walks into a McDonalds and stabs an 18-year old girl in the chest.. That's an attacker. But the semi-conscious drunk kid who hit me last year because the nurse attempted an IV when I let go to do something, that's just an unfortunate incident. For the AMS, I just talk to them and attempt to gently restrain them or keep them from causing harm to themselves or others. Also includes putting "gloves" on them... A towel wrapped around their hands with immobilization tape around it. For the actual attacker, they are no longer a patient, they're an aggressor, which means using any and all means to defend myself to the extent possible to escape the situation.

Unfortunately, in the law, the "attacker" would be anyone who causes the harm, no matter the cause. Then they'd have to prove a medical condition as the proximate cause as a defense.

OUTSTANDING! Finally an educated non "machismo" response!

An attacker is no longer a patient! It is their intent that makes the difference!

Just becasue a person is on drugs or alcohol does not negate their criminal activity and force them into being a "patient". Example....... If a person drives drunk and runs over someone.......does the court say.... "Awe..... they were just drunk.....they didn't mean to kill that child. So we should just let them go". Of course not...... being drunk makes the crime worse does it not?

 

[thatJeffguy]

Guns FTW.