When and How do you use "Self Defense" on the truck?

[Anonymous]

As my medical director says, "Psych patients are just benzodiazepine deficient."

haha this made me chuckle

 

[DrankTheKoolaid]

re

Your best bet is to instead focus your time taking some verbal judo courses that law enforcement programs teach.

Then and only then consider taking some trap lessons. Remember, small joint manipulation does not typically work on drug induced delieriums and the truely psychotic patients. For these you will need to move the the next superior joint IE wrist traps that way you can control their momentum and use it against them

 

[Kidquick]

Although I pride myself on my 'verbal judo', I'll keep a 1000cc bag of NS within arm's reach if I get a certain feeling about a patient. I've never had to resort to it, but you can knock someone upside-down with one if you get enough of a wind-up.

 

[Outbac1]

For most situations the appropriate use of your mouth and body language is your best defense. Be careful when using your mouth as it can not only get you out of trouble but can also dig the hole deeper. Remember we tend to get many customers, (often near bars), that were talking when they should have been listening.
Leave when you can and let someone else (PD) handle the problem person. "Reasonable" force is always an option but is somewhat subjective. I feel it should only be used to extricate yourself from the situation and not as a means of forcing someone to comply.

 

[MedicBrew]

Although I pride myself on my 'verbal judo', I'll keep a 1000cc bag of NS within arm's reach if I get a certain feeling about a patient. I've never had to resort to it, but you can knock someone upside-down with one if you get enough of a wind-up.

This actually works. just remember to keep the down port on the back side. Don't want to leave any marks.

1000ml NS = the old Phone book trick!!

Not that I've ever done it.

 

[Hockey]

Taser. 'Nuff said here

 

[DrParasite]

I was told once that every paramedic who gets smacked could have avoided it.

sure. just make sure every patient you have is handcuffed and leg shackled by PD before you get there.

I always like people who say every fight can be avoided. those who say it usually have a cop on scene for every EMS call before EMS arrives. They are also the ones who say every EDP should be put in hard restraints for transport. And they are also the ones who would be running the other way as their partner was getting assaulted by an EDP.

most assaults can be avoided. leaving the scene is often the best way to avoid being assaulted. the flip side is anyone still in the area (family members, children, innocent bystanders, people who are trying to help because they don't know any better) now stand to become victims for the assaulter. That is also assuming the EMS crew can leave the scene, which isn't always possible.

In a perfect world, EMS would never never get involved in an unsafe scene. unfortunately, we don't live in a perfect world.

 

[systemet]

It's not just being armed. I wanted peoples opinions on when they will engage in a physical conflict with pt's and what they think warrants it. Not only that but I would like their take on the different "self defense" modalities different Fire/EMS personnel have or are willing to use when feeling threatened. I just threw EMS being armed in there to get takes on that as well.

Opinions

* Only medics working on a tactical team should be armed, and only while performing that role.

* Most situations where violence occurs, it's due to a failure to communicate and behave like a professional.

* Any time you have to wrestle / fight someone in the ambulance, your management is going to assume you have failed at the above.

* You need to be able to motivate the level of violence you used.

I think it's only acceptable to attack someone if they have already engaged your partner, or if you believe they are attempting to access a weapon. And even then you want to control them with the least amount of injury possible and then egress to a safe location.

Even in the back of the ambulance, there's nothing wrong with pulling over and just leaving and calling the cops.

Most of these discussion becomes pure fantasy very quickly. In my opinion, you have two types of situation, the most common being where someone drunk / postictal / high / psychotic / unpleasant decides to shove you out of the way, or take a swing at you, or even bring out a weapon, but has limited intent / ability to actual injure you. The other is when you think you're about to die. There are different tools for both situations. In the latter, you're going to do whatever it takes to stay alive and worry about the legal ramifications. In the former, you might want to focus a little on keeping your job and staying out of jail.

Most people's concept of self-defence is taking an 8 hour class on pressure-point control tactics with some washed up Tae Kwan Do instructor every 2 years. This isn't effective, in my opinion. If you want to be able to physically defend yourself, it probably helps to be big and strong. It might deter smaller people from attacking you (although this is assuming your assailant is rational, which is fairly unlikely in EMS). You might want to practice some form of effective martial arts on a regular basis, e.g. wrestling, boxing, muay thai, judo, jiu jitsu, etc.

The reality is, for most people working in EMS, this is too large a time commitment to prepare for a situation (a true life-or-death) struggle that is likely to actually ever occur. You don't need to be robocop to be a paramedic, you just have to have a bit of basic situational awareness and a willingness to walk / talk away without getting your ego all butt-hurt.

 

[MediMike]

Run. Plain and simple. Legally we have the ability to break contact with the patient and get the hell out. I'm sure this depends on a state to state basis, but I'm not going to wrastle with a patient to get them to my cot without PD there.

Someone starts getting frisky in the back of the rig? I yell "MOOSE IN THE ROAD", my partner slams the brakes while I hold on, the patient goes flying, and I get the hell out. End of story

 

[adamjh3]

Run. Plain and simple. Legally we have the ability to break contact with the patient and get the hell out. I'm sure this depends on a state to state basis, but I'm not going to wrastle with a patient to get them to my cot without PD there.

Someone starts getting frisky in the back of the rig? I yell "MOOSE IN THE ROAD", my partner slams the brakes while I hold on, the patient goes flying, and I get the hell out. End of story

Running isn't always an option. If it's available it's usually the best, but not always.

 

[mycrofft]

THIS would be a good time

 

[MedicBrew]

In my law enforcement training, they called it “Escalation of force”.

1) If they use hands, you use an impact weapon or OC spray.
2) If they use an impact weapon, you use teaser or side arm.

If you find yourself in the unfortunate circumstance of fearing bodily safety and/or for your life, you do what is necessary to go home at the end of your shift. I don’t understand the stance of “We’re here to help so we should not fight back” that some have. Yes we are here to help, but ultimately you goal should be to go home to the family.

Keeping situational awareness does not always workout I’m sad to say, but you shouldn’t go looking to scrap with anyone that looks at you funny or shoves you, even if they are drunk. No one should have their hands tied to the point of fearing for their job or litigation over their life. If you lose your job for protecting yourself, then lose the job.

BUT if you can talk you way out of a fight, that is always the best approach.

 

[CANMAN]

I agree with MedicBrew, while I am not ever going out and looking for trouble, as a EMS provider I will make every attempt to go home uninjured at the end of the shift, and also don't take a ton of crap from patients as I am there to help them not put up with their BS.

If things get crappy then myself and my partner will leave. People get one attempt to cooperate in the back of the ambulance, otherwise law enforcement is transporting. I carry a 900 lumen flashlight, every call past dusk to light up my surroundings, rooms, etc and if it ever came to it a self defense tool that is right in my back pocket.

I work in a pretty shady area and it is not uncommon to just happen upon scenes that according to dispatch should be safe but clearly aren't. Example: Last November, dispatched for ped struck in a neighborhood called "Strawberry Hills" doesn't get a PD responce but stood out because the time of night (2am) and the neighborhoods reputation. Arrived on location and we have Little Johns identical brother face down on the pavement with two GSW to the chest At this point your already in the hotzone, and these kind of situations happen......Luckily for us we moved back to the unit, GTFO until LE arrived, and then went to work.

 

[airbornemedic11]

Escalation of force

You have every right to defend yourself. Yes, over-regulation and company procedures could interfere with that, such as carrying a side arm, baton, OC spray. Your question is very general, but every situation that calls for escalation of force is different. My general thought process is, I'm going home to my family at the end of my shift, in one piece. Can I avoid the situation? Do I have back up? Is my life or anyone else's in danger? Everyone reacts differently to different situations and even the same situation. I could run 10 different soldiers through the same scenario and get 10 different responses.
Generally, don't overdo it. Use only as much force as necessary to de-escalate the situation. Hooah.

 

[newenglandeve]

In most cases, it should not be a fight, but rather a struggle for restraint. The best way to restrain someone is with a lot people, not by hitting them in the head with a portable 02 cylinder. I've never used my restraints in the field before because I do not trust that two people can restrain someone without an injury.

Tigger,
As a matter of fact, there is documentation in the healthcare field that it takes a minimum of 5, properly trained and equipped staff members, to perform a restraint safely. And you are right to not use the O2 tank, as it can be equivalent to Deadly Force.

I agree with your idea about verbal de-escalation, however there are circumstances when some people can't "hear" you, whether from drugs or psychosis, which is why a Defensive Tactics training that covers all aspects of protecting your self is a good idea.

Stay Safe,
newenglandeve

 

[newenglandeve]

"Escalation of Force"

In my law enforcement training, they called it “Escalation of force”.

1) If they use hands, you use an impact weapon or OC spray.
2) If they use an impact weapon, you use teaser or side arm.

MedicBrew,
It is my understanding that the Escalation of Force concept is only applicable to law enforcement personnel. At the civilian level, you must utilize the same level of force, i.e. if they use hands, you use hands, if they use a weapon, you may use a weapon.

I'll look and see if I can find where this info came from, but I believe it to be accurate.

Stay Safe,
NewEnglandEVE

 

[airbornemedic11]

MedicBrew,
It is my understanding that the Escalation of Force concept is only applicable to law enforcement personnel. At the civilian level, you must utilize the same level of force, i.e. if they use hands, you use hands, if they use a weapon, you may use a weapon.

I'll look and see if I can find where this info came from, but I believe it to be accurate.

Stay Safe,
NewEnglandEVE

Negative, this is incorrect. Imagine a 280lb man high on meth mugging a 120lb woman using only his bare hands. Are you trying to tell me she can only defend herself with her hands because he is not using a weapon? This applies to law enforcement and civilians. You can use the minimal amount of force necessary to de-escalate the situation and/or protect yourself or anyone else. If you think you can bring that guy down with a shot of OC spray, go for it. If you think that might not work so you jump to your handy .357, use it. But you better be able to convince a jury that using a handgun was the minimal amount of force that was necessary at the time to de-escalate that situation. The magic phrase is "I was in fear of my life. I thought I was going to die."

 

[newenglandeve]

But you better be able to convince a jury that using a handgun was the minimal amount of force that was necessary at the time to de-escalate that situation. The magic phrase is "I was in fear of my life. I thought I was going to die."

You hit the nail on the head with this statement right here. I apologize if I was unclear on my explanation. I meant in a fair fight. If a 90lb Female is getting choked out by a 300lb male for example, then it would easily be found to be REASONABLE for her to "up" her level of defense.

It will ultimately come down to what a "reasonable person, placed in the same circumstances, would have done." And a "jury of your peers" will basically be deciding if they would have done the same thing if they were placed in your shoes.

Thank you for pointing that out Airbornemedic11, does this make more sense now?

Stay Safe,
NewEnglandEVE

 

[DT4EMS]

You hit the nail on the head with this statement right here. I apologize if I was unclear on my explanation. I meant in a fair fight. If a 90lb Female is getting choked out by a 300lb male for example, then it would easily be found to be REASONABLE for her to "up" her level of defense.

It will ultimately come down to what a "reasonable person, placed in the same circumstances, would have done." And a "jury of your peers" will basically be deciding if they would have done the same thing if they were placed in your shoes.

Thank you for pointing that out Airbornemedic11, does this make more sense now?

Stay Safe,
NewEnglandEVE

Heya Matt! Glad to see you posting in here!

BTW........ have you noticed how the threads like these always turn to lethal force (firearm) carry and or use?

Here is the question I pose to all here..........

Why is it that many in administration don't feel it is necessary to train their staff in personal protection but many front line staff wish to carry a firearm?

Why is there such a gap here?

I can give some reasons "I" believe this gap exists.......

1) Failure to report incidents of assault (to supervisors or law enforcement)

2) Mocking by senior staff (joking about assaults)

3) Assaults seen as part of the job

4) Staff stating admin won't back them- Funny (as in ironic)- when I meet with their admin state the safety of their staff is what is most important.

5) Probably the most important- Not separating/defining the difference between a "patient" and an "attacker/aggressor". I love when I have people in EMS who describe a "fight in the back of the ambulance" and they are really describing an uncooperative patient......

A fight requires TWO COMBATANTS.... meaning two people that want to fight!

Self-defense in EMS is unique. It is not a fight. You are either treating in uncooperative patient who is confused due to a true medical or traumatic event......or you have to defend yourself and ESCAPE and attacker. We ESCAPE from the attacker.....not try and stay too long calling them a "patient".

 

[ZootownMedic]

When? When I'm in danger.


What? Whatever I have to do, to end the threat to myself. I will be the winner. Most of the time that involves copious amounts of benzos and a few beefy firefighters.





As my medical director says, "Psych patients are just benzodiazepine deficient."

I like the sentiment but sometimes if you go the benzo route they will just end up being oxygen deficient after you knock out their respiratory drive......the only benzo we carry at the moment is Versed(we also carry Haldol but that seems to be worthless in the field with short transport times) so maybe my opinion is a little skewed. I would rather restrain them and if necessary give them some small amounts of versed vs. copious amounts. Haldol and Benadryl is always an option too and seems to work relatively well in most cases.