Protecting yourself from patients or bystanders...

[WannaBEMT]

Wanted to ask a question about how it goes in the real world with these 2 issues. If a patient does something to hurt you or your partner, what happens then, do you have the right to defend yourself, If I as a woman had someone overpower me in the back of the rig do I have to beat the crap outta him. If a bystander hurt me or my partner then what. I know about scene safety. I am talking IF this happened, what are the options and what have you done in the past. Also does anyone care to share past experiences. This is one thing I have been worried about.

Thanks for the advice up front and I appreciate all the insight you guys give, you have all been invaluable during my training process. I am waiting on my NREMT results for EMT-I right now so I have time to be back on here with you guys!

Jenn

[Asysin2leads]

WannaBe, you have to be a little more clear. Are we talking about what the law allows or what actually occurs if a patient attempts or succeeds at assaulting myself or my partner?

[WannaBEMT]

Yes that....The LEGAL way and the STREET way, is there a difference?

Thanks for your input on this matter.

Jenn

[WannaBEMT]

Should also add that I meant on my 1st post do I have the right to beat the crap outta the person to defend myself, not do I have to, sorry wrong wording.

JENN

[emsbrian]

This is a real touchy issue. Legally you have as much right to protect yourself as a civilian. In any case if there is any worry about bodily harm to you or a partner the PD should be with you. How likely this is I don't know. What I do know is that calling for ALS or a supervisor because of this worry should be ok in your service. I have responded many times just as a worry with manpower when dealing with a patient.

Now on the note of the problems: You know more then a civilian and are more accountable then a civilian. What ever you hear, "oxygen" or "clipboard" therapy is not an option (hitting them with either the clipboard or o's bottle.) Remember safety is NUMBER ONE to us, we can't help people if were dead (on that note, I once hung over the edge of a balcony with a rope tied to my belt, is that bad?) Normally your service should have pretty clear chemical or physical restraint protocols. If they don't you need to tell them that they should develop some. Even if there is not a need for spinal precaution backboards make a good restraint, but remember this is just for dangerous patients. As a rule we always restrained one arm above the patients head and one arm down, makes it harder for them to struggle, but go by your protocol. I personally have never had to use chemical restraints, as they are contraindicated by trauma, which almost all my combative s were likely head injuries, ETOH, or drugs. (a very very few psych)

Yes I know none of these answer your questions directly but I hope the advice helps.

If you are assaulted by a patient DO NOT beat the crap out of him, no matter how tempting (I'm a huge guy, it would be easy for me.) Let them out of the ambulance, once they assault you don't take the physical aspect into your own hands. If they want out let them out, call for backup to get them restrained. Remember unless PD takes them into custody you can't transport against there will if they are alert, that would be adult-napping. (Altered circumstances withheld from previous sentence) Just remember anything you should do should not be drastic, it should be in self defense in an attempt to escape the situation. Also remember to tell the police that you either received bodily harm, or feared bodily harm, and to document this well in both the run report (and incident report if harmed.) What you say is very important to what happens in court if it goes there.

On that note, as long as you are justified in self defense use of a weapon is not good, but mace (pepper spray) is fine. But I would not use it in the truck, as everybody will end up suffering, including you. We always were happy to help worried medics, so don't be scared to call for backup, although not for every call. Don't let anyone tell you its the wimpy thing to do. There is a lot of old boys club in this game, and we don't need to loose anyone because she/he was scared to be made fun of.

I have not had many bad experiences with patients, two of my worst were one who was restrained backboarded and got out. (velcro restraints were protocol, we had to upgrade) He hit me in the face with his fist, I layed an elbow to his chest and restrained his arms while sitting on his chest until my partner pulled over to restrain him again. The other I was driving my (small female) partner pushed narcan and the patient reacted well (if you call it that) to it. She yelled I pulled over and ran around back to see a half naked druggie running down the interstate. Both of which we filed incident reports on. The first told the doctor I sat on him, which went around to the police which came back to my report which justified it. (No problems at all). The second the police were called to get the idiot back so no problem there.

So SUMMED UP:

-SAVE YOUR SELF AT ALL REASONABLE COSTS

-AS long as your trying to escape the dangerous situation and document the shit out of it your safe.

[Asysin2leads]

Okay, so now that we've made the difference:

The legal way:

The law provides for the reasonable and necessary force needed for a reasonable person to extricate themselves from a situation that provides an immediate threat to life and/or health.

The other way:

Male, 29 y/o is laying on a hospital bed in cuffs blowing blood from a broken nose all over the ER, next to an injured paramedic who is nursing nasty bruises to his person.

Cop: "The subject was violent, intoxicated, he fell prior to EMS's arrival."

Me, to injured paramedic's partner: "He fell, eh?"

Partner: "Yes, prior to our arrival."

Hope everything is clear. Stay safe.

[Ridryder 911]

A couple of things.. http://www.dt4ems.net/ is an excellant Paramedic and LEO/martial art instructor that has developed "self defense" courses to safely protect you and the patient. Take a look at his site, he might be able to answer your question more in detail, he is a very nice guy.

The second is dependent of the cause (i.e. CVA, head bleed, diabetic, patient not aware of what they are doing). If the purposefully hurt me I file formal assault and battery charges, if there is damage I will SUE them as well. When I was ER manager, I encouraged staff to do this.. and suddenly the word of mouth went across town the nurses will not take sh*t.. be careful! After a night in jail and a hefty fine.. they get the message.

Many administrators do not want to " hurt their image".. my answer is fine.. cough up some cash and cover all my expenses. If you were injured be sure to get evaluated and potentially file workman's injury.. this will get the administrators attention as well to get courses like I described as well as encourage legal action.

Good luck,

R/R 911

[emsbrian]

As far as assault and battery charged, definitions change state to state, but in Texas assault is verbal and battery is physical. Either way unless some serious damage was done to you it is extreme to file charges. We are as a matter of our job, placed in a number of dangerous situations. Physical harm comes from people and situations if EMS is sueing and having patients charged they will be scared off and not use the system.

It is not the reputation of the service I fear as Rid said, except that the one he earned his ED may have been a negative one. The ol' you catch more flies with honey applies. Most patients respond to a "I'm here to help you" attitude over "fear me." Which is not to say I have never been stern to the point of truly ordering patients when needed. On that note your service should help you out with the decision to press charges if need be. And any expenses should be covered by your insurance (you do have some right????????????????) So why Rid is a wise man, I fear his advice is brash in this case.

[iMac]

The legal way:

The law provides for the reasonable and necessary force needed for a reasonable person to extricate themselves from a situation that provides an immediate threat to life and/or health.

Thats what I woud follow.

[Ridryder 911]

Apparently you are not aware that the ED & EMS is considered one of the most dangerous spots to work. We are there to help them not be abused by them ! What gives them any more right to harm, abuse, and violate us ? .. If one is incapacitated that is another thing, but to make a conscious decision NO !

Name any other place in business that would tolerate assaults to employees and staff. Far as "running them away" how many empty ER's have you seen lately, as well are these the ones that management really care to have in their ER ? If one can not behave appropiately then stay at home...

Sorry, after one of my nurses received 3 fxr. ribs and a displaced sternum, because she applied the BP cuff to a drunk, or a medic received a fxr. jaw because she refused to be "felt" up .. I have no sympathy. Either behave in an appropriate manner that is reasonable or get the hell out of my ER or ambulance! No where does any curriculum, work description describe one has to be tolerable or be abused by patients verbally or physically. If you cannot behave, I will have an officer to assist you out the door! Management, is always afraid. They did not like I encourage action until they had a nurse suggested they had inadequate security, and threatened to sue them as well. That changed their mind set immediately.. and from then on developed a policy to make an I/R and police to be notified dependent on the case.

Even some of ER Doc's have pressed charges and testified in court, enough now that the Judges know they mean business. We in the health care have an obligation of taking care of patients, but take care and protect our selves as well.

Again, before anyone makes excuses I am not discussing medical or trauma patients that represent behavior disorders such as diabetics, senility, trauma, etc.. That itself is a related side effect and proper restraining (either chemical or physical) should be advised.

R/r 911