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

[ZootownMedic]

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."

Yep thats true. Cops and civilians alike have fired on unarmed people more than once and it was usually because they were outnumbered or the perp tried to grab their weapon. If you go for a cops weapon at all he can kill you without having to do much explaining.

 

[usalsfyre]

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.

If the only "depressant" on board is a benzo your pretty darn unlikely to completely knock out their respiratory drive. Benzos rely on endogenous GABA...there's only so much of that floating around. Not to mention agitated patients don't have much of that system activated anyway, so it may require larger than normal amounts to ramp it up. If they need it throw them on a NC and fix it. Your patient is much more likely to end up oxygen deficient at the cellular level (where it really counts) struggling against restrains while inadequately sedated.

Plus, you've got multiple tools to fix hypoxemia from a depressed respiratory drive. How well can you fix lactic acidosis, rhabdo and hyperthermia? As a profession we've really got to stop being afraid if sedation.

I've given upwards of 20mgs of versed over a 20 minute transport and never seen someone stop breathing. If there's enough stimulation they need that much it's unlikely they're going to crump from a respiratory drive issue.

 

[Shishkabob]

If you go for a cops weapon at all he can kill you without having to do much explaining.

Heck, you go for their TASER and they can shoot to kill.

I've given upwards of 20mgs of versed over a 20 minute transport and never seen someone stop breathing. If there's enough stimulation they need that much it's unlikely they're going to crump from a respiratory drive issue.

Remember the amount of Versed and Ativan we carried at ol' Burgandy? Gave darn near all of it once to a status epilecticus, and she still had decent ventilatory effort in between the seizures.

 

[Basermedic159]

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.

I would rather them be oxygen deficient AND knock out their respiratory drive with benzos, and just add a paralytic to the mix, rather than them 'permanently' knock out myself or my partners. I've had about a 120 lb female PT high on amphetamines and a bunch of other drugs. This pt was combative and VERY violent. We unloaded almost our entire narc box on her. We gave Versed, IM Haldol, Valium, Etomidate and even fentanyl I believe. After all these meds, she was still fighting us. This was back before we a true RSI. We only had Etomidate, Versed and Fentanyl to "RSI." If that would have happened now, she would get Versed, Sucs and Roc. That'll do the trick!h34r:

 

[jameswf]

I have carried since I was of legal age to do so. In my daily life I carry concieled. I am a big advocate of the need and inherant right to defend one's self. In 9 years of being armed I have drawn my weapon in defense exactly 0 times. I have had it out to clear a house a few times but never pointed it at anyone. Now In the same period of time I have been in several confrontations. I am a big guy who towers 6'4" and 300lbs. When your a big guy people seem to have something to prove and you become the focus (WTF). I am not a fan of being hit and I am not motivated enough to go punch for punch with anywone. In these sort of cases I use pressure points and control. I will sit on someone until help arives anyday. I also have a bi-polar son who stands 6' tall 230lbs and he is generally well controlled. The beauty of bi-polar is that if something triggers he becomes a raging linebacker in the blink of an eye. For obvious reasons I am not going to box it out with my kid. These situations are all handlesd with simple control no need for anything more especially not a gun. I think EMS carrying guns would be counter productive. The first rule of gun's is don't point it at anything you don't want to kill. It is not your job to kill people so voids out the whole purpose of a gun. I think you learn the pressure points and maybe throw in a bear hug. should cover 90% of situations. Also if you have the choice run away. I would rather be an alive coward than a dead tough guy.