Violent Patients

[eggshen]

Does anyone out there have any policy or program for dealing with violent patients, family, bystanders and so on?

Egg

 

[Medic's Wife]

I would imagine that every service has their own protocals regarding that, no?

 

[Jon]

Oxygen Therapy.... 512 Liters of O2 at once, only I forgot to take it out of the bottle!

 

[Medic's Wife]

ROFL!

Hubby has had to tackle some drunk guys from time to time...wonder if that was in the protocol....... :blink:

 

[Jon]

ROFL!

Hubby has had to tackle some drunk guys from time to time...wonder if that was in the protocol....... :blink:

Never is.... they write protocols for almost everthing... then we make up the rest as we go along.

 

[firecoins]

Easy,I use the cops to arrest them. If they aren't around, there isn't a back up plan

 

[Emtgirl21]

I got into my first fight with a patient last night. I just keep them from hurt me or myself until PD could get on scene and take over. This is how it is plain and simply.....i go home at the end of my shift with all my body parts in working order and in their proper place
.....thats it.

 

[chico.medic]

They were "seizing" and I IM'd them w/ 10 of versed:blink: ...that in turn knocked out their respiratory drive, and here we are w/ a nice, quiet, cooperative and intubated patient. B)

** Before anyone calls me out on my dosage, I WAS JOKING. **

But to answer your question egg, My LEMSA has a policy that allows us to "chemically restrain" a combative subject.
It states "requiring intubation", but we can get away w/ quite a bit as long as we get a BHPO. (Base hospital PHYSICIAN order.)

 

[DT4EMS]

There is a whole site dedicated to this.

It is www.dt4ems.net

Actually Phoenix Fire is one of the only places I have found with an actual "policy" in place. Do a little digging.

BTW, Chemical restraint is under some big reviews right now. Be very,very careful with liberal use.

Don't forget the NAEMSP has taken the position that it requires 5 people to "medically" restrain a "patient". So if someone gets injured (you or the patient) and the "experts" say it takes 5 people and you tried with 2-4........... uh-oh. some one will write a check if a lawyer is familiar with restraint cases.

 

[eggshen]

I may not have expressed myself thoroughly enough. Any policy regarding actual physical self defense and so forth. Restraints come after the fight.

 

[chico.medic]

erm.....none written. Bite, claw, punch, scratch, kick, slap, beat, or whatever it takes to go home breathing.

 

[Airwaygoddess]

I have been known to put large pieces of medical equipment between me and a violent patient....:wacko:

 

[LIFEGUARDAVIDAS]

Regardless of your service policies and procedures, I advise you to take some formal training in self defense for both, when you are on duty and off duty.

Some states allow carrying a tonfa (PR24/ side handle T baton) with prior training. Holding one of these or even just carrying one will avoid rowdy behavior 95% of the times. For the rest, by using a baton (contrary to the public's believes) you'll avoid hitting the oponent (and its liability afterwards), since most techniques are for proper restraining until LE arrives and not for "fighting with a stick."

Besides that, I recommend everybody to learn and practice a martial art since it'll contribute in many aspects of the student's life, and actually will help to prevent engaging into fights and violent incidents.

Best of lucks and exercise caution 24/7

Guri

((there is a reason why most professional lifeguards carry a rescue can at all times while on duty))

 

[eggshen]

Hey DT4, does Pheonix use this "system"? Do you know of anyone who does? Here were are putting in place a "use of force policy" and I am trying to get some ideas on how people run it. We are beginning our first class next month using the PPCT Violent Patient Manegement program. Does anyone know of ANY other agencies that use this or any other specific traing? Any and all info or advice is welcome.

Thanks
Egg

 

[DT4EMS]

Hey DT4, does Pheonix use this "system"? Do you know of anyone who does? Here were are putting in place a "use of force policy" and I am trying to get some ideas on how people run it. We are beginning our first class next month using the PPCT Violent Patient Management program. Does anyone know of ANY other agencies that use this or any other specific traing? Any and all info or advice is welcome.

Thanks
Egg

I train EMS in Use of Force. I am a former PPCT instructor. I encourage YOU to speak with police officers you trust, who trained in PPCT, BEFORE adopting the violent patient management program. Then you can make an informed decision, not just a decision based on good marketing.

I think the world of Bruce Siddle, but PPCT because PPCT became soooo big, a lot of their instructors (watered down versions) don't keep the integrity of the program and focus TOO much on the parts of the program that don't actually work in real life.

Read the testimonials on www.dt4ems.net from real EMS providers and see what they have to say about DT4EMS.

 

[Recycled Words]

We have PD respond on all calls. When they aren't availible, we approach with caution, if there's a sign that the patient is combative or becomes combative on scene, we request cops and if they don't show, we don't go in.

If a patient is likely to become combative en route to the ER or is already combative, the cop(s) come in the rig with us and keep 'em restrained.

 

[medman123]

What can you carrie to protect your self. Any rules about what you can carrie.

 

[BossyCow]

What can you carrie to protect your self. Any rules about what you can carrie.

I think that's pretty much up to the agency. Around here our volunteers still show up to calls with the shotgun still in the pick up truck gun rack. Personally, I don't want to have anything on me that a pt or bystander can get away from me and use on me. I prefer to use my wits and a healthy fight or flight mechanism to avoid problems. I've had more issues with pts who were too friendly rather than too violent.

 

[DT4EMS]

The latest study (completed by McNeil and the NAEMT) stated the number one injury in EMS was due to ASSAULT. 52% of providers polled had been injured due to an assault from a patient or bystander. 47% had had a back injury from work.

Now, you get trained on how to "Lift and Move" patients but how many get training on how to recognize, avoid and defend (if needed ) a potentially violent encounter?

To think you will never have an "incident" occur is like pulling the cover over your eyes as a child. You know, if the monster doesn't see me it doesn't exist....

Preparation is not paranoia. Why do you wear a seat belt? Are you "paranoid" you will be in a crash or do you wear it for "just in case"? Same approach to take for training in DT4EMS.

 

[Jon]

Thought of the day, to agree with Kip... at work, as PPE for violent encounters, I carry OC spray/foam and handcuffs... and am trained to carry a firearm.... On the ambulance, my sole PPE for violent encounters is a level IIa vest, a portable radio, and my head (the most important)

I rely on some of my skiills from MOAB (talking someone down) and try to avoid getting/staying in a hazardous enviroment if I can.

Why not equip us with some of the same protective tools issued to LEO's and priviate security staff?