EMS first for me

[AZCEP]

Whose idea was it to even give her that choice? If she's mentally incompetent enough for you to take against her will, then she is mentally incompetent to strike a bargain with too. Screw the "Deal or No Deal" approach. Tell the cops she's going restrained, or she's going with them, period. I'm not going near her until she is restrained. That's covered on Day 1 of EMT school.

I think you may have found the problem there Dust. :wink:

[Don1977]

Responed to a home for a "routine" psyche transport. A patient with suicidal ideations. Arrived on scene and the police inform me that not only is she suicidal, but she also threatened to stab her mother. Pt is a 14y/o female with a past history of Bi-polar.

Went inside with police escort and tried to explain what was going to happen (ride nicely with the paramedic or ride nasty in handcuffs and various other restraints.) Apparently I was no so convincing and she assulted me (okay, she hit me in the arm as hard as an average 14y/o female can). I guess what I am trying to say is that I got beat up by a 14y/o girl for my first assult. How embarrassing. The police really put it to her, but to her credit she put up a good fight. I can laugh about it, you guys take it and roll with it if you want to.

Thats why EMS should not deal with psyche emergencies!!!!! Police matter! Like I said before!

[Baldrick]

Thats why EMS should not deal with psyche emergencies!!!!! Police matter! Like I said before!

I have to disagree with that. They are ill, they still need help. I once went to a slightly irritated 90 year old on a transfer who was a psyche patient and convinced we were the police it took 45 min to get him into the ambulance with the aid of a nurse escort. Yes he was a bit argumentative but he was also hyperkalemic and in danger of suffering arythmia etc.

Is an upset 14 year old crying on the floor who has also popped a load of paracetamol not also a medical issue.

Aside from the fact that many of these people have or may have an underlying medical problem that needs to be assessed and treated they are suffering from an illness so it is right they are seen by health care providers.

However I would agree in so much as if there is any possibility of violence or it is reported as violent you get the police there and in the room first and work in partnership.

Or am I just be idealistic again?

[DwayneEMTP]

Thats why EMS should not deal with psyche emergencies!!!!! Police matter! Like I said before!

So are you then saying that hypoglycemia, stroke, overdose, hyperthermia, head injuries, and many more MEDICAL issues are also police matters?

Or simply that the police are more qualified to assess these patients than you are?

Unfortunately, you're showing why many people have a hard time respecting vollies. The above statement screams to me "Don't bother me with these difficult, yet non-glorious patients! Hell, it would be just my luck to miss getting on T.V. at a car crash while I'm screwing around with these Bozos!" (Aimed at the vollie stereotype, not all vollies in general)

You're one of the most frustrating kinds of posters for me. You seem to be smart, even dedicated, yet you continue to make these types of statements. It's as if you're repeating nonsense that you heard somewhere, thought it sounded cool, yet didn't bother to run it through your own mental logic filter first.

I truly look forward to the time that you become committed to one of these subjects, and we are exposed to your true, passionate, personal arguments.

Dwayne

Edited for typos, no content or context changes.

[spenac]

I do not think that EMS should physically take down patient. That is police job, that is what they are trained for. After they have patient secure then we can check medical condition. I do not think all emotionally disturbed patients really need an ambulance to transport them. Often they need a mental health professional to evaluate them and police can transport them just as well as we can. If we transport a violent patient they must be in restraints and have law enforcement riding with us.

[Richard B the EMT]

Seeing it was Spenac thought I was the EDP, I have to borrow someone else's signoff, "Why am I not surprised?"

Anyway, when you hear what sounds like shooting close at hand, and your partner is yelling in your ear to get down to the next lower floor, and is leading the way so fast, the equipment he's carrying is still falling from being unattended in midair...get the idea?

[spenac]

Seeing it was Spenac thought I was the EDP, I have to borrow someone else's signoff, "Why am I not surprised?"

Anyway, when you hear what sounds like shooting close at hand, and your partner is yelling in your ear to get down to the next lower floor, and is leading the way so fast, the equipment he's carrying is still falling from being unattended in midair...get the idea?

Sounds like you partner lives by the philosophy that he doesn't have to faster than the bear (bad guy, EDP, etc), he just has to run faster than you.

[Richard B the EMT]

Hey, I used that line here somewhere within the last month!

[FireGuard69]

Thats why EMS should not deal with psyche emergencies!!!!! Police matter! Like I said before!

CONTENT REMOVED - ADMIN

[EMDP2081]

Alright, here is my 2 cents (making my hourly wage even more menial and demeaning), Mental health is a pandemic. it is a burden because it is not profitable. if it were profitable and not operated primarily on reimbursements from government funded healthcare, every one would have all of the Mental Health care that they need and deserve, but that isn't really an option if you don't have a trust fund.

EMS has inherited Mental health in alot of parts of the country because of the legal position it places Law Enforcement in. In MN, the law read something to the effect that PD is responsive for Mental health Transports unless there is no viable option for transporting the patients or they are unable to. Since most departments are understaffed, EMS is now a viable option and in most places, EMS is the policy. In stead of rebuking that "gift" we should instead focus on how we can do a better job of dealing with our responsibility.

I don't necessarily think that restraining Mental health patients is a catch-all intervention applicable 100% of the time. I'm still a new medic, but in my 3 years of being a medic and 2 years working as an EMT, and having completed roughly 4,000 calls, i honestly think i can count on two hand the number of times that i have restrained a patient and i have never gotten thumped by a patient. Maybe i have been damn lucky, maybe I am just that good looking that patients don't want to injure my beautiful face, but either way, i believe that there is alot to be said about being civil with a mental health patient because they are still people and in their time of emergency, they could really use all of the dignity we can offer.

What is the correct tool for the termination of Status Seizures? Restraints? they are shaking and moving uncontrollably, just like a patient experiencing a mental health emergency!

Calmly talking with your patient and getting to know them and maybe listening to their life story (although often a can of worms) is probably my most effective tool. More effective than restraining, Haldol, Benadryl, Ativan, Versed or any other intervention is a empathetic (albeit still pathetic) Provider who is able to connect with their patient and genuinely try to make a connection with this patient. That is what i find effective and typically highly effective. Just like our mothers taught us, wear clean socks, don't put your finger in there and always remember the golden rule. You wont get anywhere with a Mental Health patient by being a douche to them.