Unsafe scene encounters

[mrsmall]

I'm curious to hear some of your stories of when a scene became unsafe...

I've heard a few from around here, and been working on a night when someone's gotten into some trouble. Luckily I've never been caught in a sticky situation.

[akflightmedic]

Oh boy, this thread could turn into a great learning tool for all of us, noobs and vets.

One that stands out in particular was when we were requested by PD for unknown medical on side of highway. When we get there, there is a woman in her early 20s, standing beside an officer. The officer states he found her walking along and she will not respond to anyone, nor will she make eye contact.

I asked her a few questions and she starts to sniffle and cry. She is also hugging herself like a woman who is scared or just been through something bad. In my mind I am thinking she has been assaulted somehow and since I dont see any obvious signs, I am thinking sexual assault.

I asked her if she was sexually assaulted and she starts to wail, but then goes back to this "catatonic state" after a minute. I guide her by the arm to the ambulance and tell the officer we will take her in for evaulation. She goes compliantly with no issue, and I have to lift her leg to make her understand to step up in the unit.

I placed her on the stretcher and secured the straps (all of them). I proceed to sit on the bench seat so I can see her and note nothing out of the ordinary. Basically I did not exist to her as she would not acknowledge me. I started doing my paperwork and after a few entries I put it down so that I may take a blood pressure.

At this point, we were en route to ER maybe 8 minutes out with a police officer behind us, not close but back there somewhere. He was simply going to ER to do follow up as well, not that we requested him. I picked up the BP cuff and then lifted the womans left arm and it was at that moment that she went total ape shit. She started screaming and attacking me. She swung at me and scratched me as well.

I jumped on top of her with a knee to the chest and pinned her to the bed and then restrained her arms. SHe was shaking me off, it was quite the struggle. Her eyes were maniacal. My partner is wondering WTF when all this happens and I screamed to him do not slam brakes but pull over and HELP. He immediately got over and ran to the back to assist me. I am 6ft andat the time was in the 240lb range, my partner was 6'3 and 260 and this woman was tossing us all over the rig.

One of the things that helped us was I had buckled all the straps. The chest strap prevented her from harming me more than what she did initially. When she tried to sit up fast it had enough slack where she got some momentum but then jerked her back to the cot.

The officer pulled up as we were on side of the road with back doors open as traffic was flying by and me and my partner are wrestling this woman. He comes running over with his mace and I am like NOOOO, not in the truck! Man I hate that shit.

Anyways, he jumped in and helped us handcuff and cravat her limbs to the stretcher and then we proceeded on into the ER. The woman was on and off again, between catatonia and violence.

The ER did their assessment and found she had a whole assortment of drugs in her system. She had not been assaulted, she was just whacked out.

Morals of the story:

1.Always use the cot straps.

2.Never drop your guard, always think they are going to swing at you, even that sweet little old lady from the nursing home with Alzheimers.

3.Maintain a high index of suspicion for everything, from differential diagnoses to how can this scene go from good to bad to worse.

4.After thinking about #3, always have a plan of what you will do if anything should occur.

This call blew my mind, cause I went from the gentle, empathetic caregiver for a possible assault victim to placing my knee in her chest, pinning her arms and dodging bites and spit in a matter of seconds.

[strippel]

My partner and I had a probie with us. Got dispatched to an emotional problem about 2 blocks from our station. When we arrived, there was one police car on location, officer was typing on his computer. There is no history with the patient or the address, so the officer asked us to go first.

The patient's wife is standing on the front porch, and states that her husband has been under stress lately, and today he is "irrational". He has never been violent. The patient is standing in the back yard. We walk to the back yard, and have a pleasant conversation with the patient. Mid sentence, the patient stops, looks at the probie, and states "I am going to rip your head off". We say "thank you and have a nice day", and walk out front to talk with the officer.

The officer is talking with the patient's wife, another officer has arrived. The officer has the patient's phone in his hand, and is calling mental health. The patient comes running through his house to the front porch. He takes one look at the officer, and punches him in the face. My partner grabs the wife, I call for backup, the other officer runs up with his baton swinging.

The patient is larger than both officers, they are unable to control him. Luckily, more officers arrive quickly, and the patient is hand cuffed, and taken to the station.

Our supervisor arrives, and asks where our probie is. He has hidden in the ambulance, locked the doors, and is hiding on the floor, trying to squeeze under the litter.

[dahlio]

Went once to the short of breath, and went in to a home in the suburbs. It appeared to be a lady in her mid 40's who was a bit short of breath. Oxygen was put on her, and my partner started getting information. I start taking vitals, and in the midst of a blood pressure, a man comes out from the kitchen, with a baseball bat, screaming at us, "What are you doing to my mom!" The man starts at us, and he tells us to get the hell out. Left the blood pressure cuff and oxygen inside, as both me and my partner bolt out the front, to our ambulance, and pull a block away. We request the police, and they eventually intervene, and get the son away (No idea whether he was arrested, but I would hope so). Finally go back in to the house, and the son ripped the blood pressure cuff off, and broke the dial. Not sure what we could have done to really prevent this, since the scene did not appear to be unsafe. Freaked me and my partner out for the rest of the day. Definitely learned to expect the unexpected though.

[JPINFV]

Our supervisor arrives, and asks where our probie is. He has hidden in the ambulance, locked the doors, and is hiding on the floor, trying to squeeze under the litter.

The funny part about that is that the contents on the floor of an ambulance are probably much more dangerous than anything that patient might be able to do with the number of people on scene/responding.

[jsadin]

Called by PD for a potential section 12 (psych) sitting in a car in a driveway. We arrive to find 4 officers on scene and a mid 20's female sitting in the drivers seat of a small car. One officer tells me he was driving by and noticed this young lady sitting in the driveway with the car in park, the accelerator to the boards and giving him the "death glare" as he drove by. He had removed the keys from the ignition by this time. I attempt to speak with her and she just screams at me at the top of her lungs, yelling about her brother and how she's going to bite my nose off, etc. I decide she's not coming willingly and ask the officers to remove her from the vehicle. These were four good sized cops and this was not a big girl, but she gave them a run for their money! We finally get her out and cravat her arms above her head and her feet to the bottom of the stretcher. She's now sobbing softly and I figure she's about out of energy after fighting with PD. We get her in the back of the ambulance and I have my partner jump in front to drive and one PO stays in back with me. No sooner do the back doors close than this little lady loses her frickin' marbles and rips the cravats off the head of the stretcher! Impressive. All four cops are now in the back of the ambulance again and I'm breaking out the four point restraints (in retrospect, I should have set them up before we moved her out of the car, but I digress). She screamed at me the entire 20min ride to the psych ward and fought us tooth and nail when we transferred her over to the hospitals restraints. Last I heard she was transferred to a long term psych facility.

I can't begin to imagine what the scene would have been like had she gotten a hold of a knife or other weapon. Yikes....

edit for grammar

[akroeze]

What I don't understand is why these violent psych patients are going in by EMS? They could just as easily be brought in by PD and would not be tying up an Ambulance that can't do anything for them in that state anyway.

[mrsmall]

What I don't understand is why these violent psych patients are going in by EMS? They could just as easily be brought in by PD and would not be tying up an Ambulance that can't do anything for them in that state anyway.

Can you always know what their altered mental status is from?

[Mateo_1387]

What I don't understand is why these violent psych patients are going in by EMS? They could just as easily be brought in by PD and would not be tying up an Ambulance that can't do anything for them in that state anyway.

For the violent ones some IN versed would calm them down so they are not a danger to themselves or others and prevent injuries to them. After the arrive at a facility they can then diagnose the patient and treat them appropriately.

[akroeze]

Can you always know what their altered mental status is from?

No you can't, but if you can not adequately control them in the back of your truck then what benefit are you to the patient? Why is it we transport the patient and have the cop follow us? We should be following the cop who is transporting the patient and only in case the patient goes downhill.