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Did a FDNY EMT Assault a Patient? The NY Post is there!


JPINFV

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It's going to be a bit hard to justify self-defense even from spitting if the patient was truly restrained...but he might not have been (might have been in the process of restraining, etc). As far as the cop not saying anything, if the patient was being combative in the slightest, at least around here, I wouldn't expect the cop to say anything either, even if it was unjustified force.

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I'm not crucifying the EMT. What I'm discussing is the ethics of punching a patient, restrained or otherwise, and the benefits and risks of restraint tactics. I don't necessarily need to know exactly what happened in this situation; analyzing the idea is good for the moment (since that's all we pretty much ever get to do from news stories anyway).

If the patient is threatening your life and immediate safety, and there is *no other* recourse, then by all means whack them hard enough to buy you time to get away. Spitting? Doesn't sound like it's immediately life threatening (especially if you're wearing the gear you should be) and really doesn't sound worthy of a punch.

That's my opinion.

Wendy

CO EMT-B

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When you are put in a violent situation by a pt you need to make sure you are well protected. This means using force greater than or equal to that which the pt has. That is why we call so many people in when there is a problem in the ER. In the field you don't have the luxury of calling everyone and their mother, so additional force may be needed. I can't say whether it was justified or not in this case based on what was given here, but crews should have every right to do what they need to do in order to protect themselves.

Eydawn, I don't think your clients come under the same umbrella as this guy. Your clients have issues that they did not ask for or bring upon themselves. I don't think anyone would consider using such force on them. The same should go for people with head injuries. If you are drunk or high and become violent, you have no one to blame but yourself for the force used against you.

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The hard part is, ERDoc, there are many who would. Not just saying in EMS, just saying in general. Just saying, if spitting was the issue here, and that was the response (as presented theoretically) then it was an overboard response.

Yes, use enough force to get yourself out of the situation... but ONLY enough force to do so, and that line is always very fine.

Wendy

CO EMT-B

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The hard part is, ERDoc, there are many who would.

No doubt about that. Nanny cams show us everyday what people are willing to do to the defenceless.

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Eydawn, I don't think your clients come under the same umbrella as this guy. Your clients have issues that they did not ask for or bring upon themselves. I don't think anyone would consider using such force on them.

Recently, locally, there was an autistic man that had his arm broken while being restrained.

When he refused to follow orders the police took him down...Ironically, his arm was broken by a medic that jumped in to help...

This is the way I heard the story from an ER doc, I have no other confirmation. It did lead us to an interesting quesion though....

How do you tell the difference between an autisic and a Paranoid schizophrenic? Not clinically, but on a level that would allow law/health worker to handle each appropriately.

Dwayne

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I think anyone with a medical/psychiatric issue deserves the minimum amount of force necessary. Unfortunetly that will occasionall result in them getting hurt. As for someone that has created their own problem, ie drugs, sometimes they need to be quickly put in their place by a show over force, sometimes you need to use that force on them. Better someone strung out on something get hurt than someone who is providing care.

I did take care of a kid with Asperger's Syndrome (kind of a mild form of Austism for those who don't know) recently. He had fallen and split his nose. This kid was 15 y/o, 6'4" and 250lbs and deathly afraid of needles. The only way we were going to get his nose closed was with sedation. I tried to give the kid oral versed. It usually works pretty well, but of course Murphy was looking over the ER that day. This kid had a paradoxical effect and became aggressive. He ran out of the room pushing all of the nurses to the floor. He went running down the hall with 3 large security guards hanging off of him. Looking back on it, the whole scene was pretty hilarious seeing these huge security guards hanging on to this 15y/o kid and they couldn't bring him down. It took 6 or 7 people to finally get him down. Luckily we were able to do it without hurting him. He ended up with a needle in his arm for procedural sedation and he sucked up the ketamine like candy.

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Ooops, Note: When I said and ER doc, I wasn't referring to OUR ERDoc. Just to be clear.

I certainly understand you wouldn't want to use unnecessary for of someone mentally challenged, and I'm not sniping at the medic for the broken arm. What made me wonder is one of the medics I rode with, who I found to be an amazing medic, told me that he is terribly uncomfortable around "retarded" people. He was in no way attempting to be offensive, simply honest, and found his feelings curious.

He said, "If I knew a person was autistic I would attempt to keep them calm and call to see if someone was working that understood the disorder. But how would I know the difference between an autistic, that I have no idea how to deal with, and a paranoid schizophrenic that I've dealt successfully with often?"

I haven't had experience yet with the latter so asked for a description of their behavior...and had no idea how to tell them apart. So I asked one of the smartest people I know. (I won't name her here, but she works with special needs people, and at boy scout camp, and NEVER has a misspelling in her posts...anyway, it's a secret. :P ) And SHE didn't know!

So I've set out on this quest to find a way to identify people that fall within the autistic spectrum, succinct enough to fit on a 5x7 card, yet able to be understood easily so that EMS/Fire/Law enforcement/ED can identify autistics and learn to treat them appropriately.

I'm clueless. I can certainly define the stereotype qualities associated with autism, but they so often overlap with the paranoid schizophrenic that I'm not sure how to explain to the uninitiated how to tell the difference...any ideas?

Dwayne

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