How To Handle Violent EDP's?

[DaveTFD 0]

when you get a call for an emotionally disturbed person do you assume they are violent? what precautions do you take?

personally i have had a few bad experiences with EDP's, 3 days after i got my EMT cert i went on a call for an EDP. it was a 17 yr old male. he wasent acting up at all, and we even carried a good conversation. when we got into the ambulance PD asked me if i wanted a ride along and stupidly i said no. enroute to the hospital the kid pulled a knife on me and almost stabbed me. i was able to restrain him but in the process i broke 2 of his fingers by accident.

now when i get an edp i always take a cop with me, i have him patted down before we get into the ambulance, at the first sign of violence he is restrained and i put a NRB on his face so he cant bite or spit at me.

what do u guys do?

[ny10570 745]

You've gotta play it out by ear, but ALL WAYS check the patient for weapons. You don;t need to do a body cavity search, but if there's any indication of violence you've gotta at least check the pockets. And then the patient, like all patients should be arapped up in a sheet and strapped up. As for bringing a cop. 9 times out of 10 they make the situation worse through no faulkt of their own, but they're cops. People tend to fear them. If I'm willing to transport the patient then I'll be comfortable having the cop follow, but the cop all ways follows.

[Guest WolfEMT]

Having an EDP in the back of the bus is a very delicate situation. In most cases, I have PD ride with us and with a chase car immediately behind the rig. However, there are some cases when PD cannot ride either in or behind the ambulance, and these cases are the most critical.

Checking for weapons is key. Coming from a law enforcement background, I know how some EDPs and other individuals conceal weapons in what may appear to be an innocuous, everyday item such as a belt buckle. The next key issue is keeping the patient on the cot. If you have 3 people on a rig (1 driver and 2 EMTs in the back), then I usually have my partner talk to the patient while I put them on the cot, making sure that the patient does not notice the fact that I inverted the buckles for the cot. (Instead of having the release mechanism pointing up, I invert it so that the release button is against the patient's body, making it a little harder for them to pop out of the belts.) The next very key issue is to keep the patient talking, but within reason. Keep it at a normal volume and always maintain an understanding tone. However, if the patient does become beligerant, non-compliant, and/or combatitive, have your driver pull over and radio for PD to meet the ambulance at your location. In many areas, the threat of violence against EMS personnel is treated with the same degree of severity as a threat of violence against a Police Officer, so PD response will be quick and will probably bring out multiple units including supervisory personnel.

Dealing with EDPs is a tough situation because it can change suddenly and without warning. The trick is to maintain a high level of professionalism, and be understanding, yet firm if the patient decides to act up. Always keep the safety of yourselves and your crew as the number one priority when treating an EDP.

[cas2383 22]

2 Words: Cattle Prod.

(jk)

[ajsbear 11]

not "baseball bat?"

[ems-buff 81]

What about an O2 tank! LOL J/K

[x242Steve 1]

Anyone here dealt with a reported EDP that turned out to be a guy/girl on PCP?

Does that stuff really make them feel/have super-human strength?

"Drugs are bad, mmm'kay"

[roeems87 0]

Whenever you have an EDP, plain and simple, have a PD car follow you. They can typically see right in the back of the ambulance if they are behind you. If anything goes wrong, you say your partner's name and they pull over. The cop will be in the back of the ambulance before you can say "help." It's an interesting thing to remember with a possibly combative EtOH. The nearly unconscious versions are not necessarily what you need to worry about, but the ones who are more reluctant to cooperate (or when the have the choice given to them of the back of the ambulance or the back of the police car), you should have a cop follow you. Bottom line, if you don't feel comfortable, you have to make a decision. If a cop can't be spared, you call your supervisor, medical control, or the dispatcher and figure it out.

On a side note. I had an MVA patient, drunk (possibly slightly altered), 17 years old, not very happy in the back of my ambulance. We had two patients, two EMTs. Both boarded (bench and cot), one EMT in the captain's chair and I was in the aisle between the two patients. The patient on the cot got slightly combative and broke himself off the backboard (broke the buckles and ripped right through the tape holding his head down--and he was down tight, it took him a few tries, despite our attempts to calm him down). We were on the BRP en route to the medical center in the Scarsdale area. Once he broke off and started swinging, the driver had already seen this coming, pulled over and was on the radio calling for PD. 60 did an amazing job with that (getting us PD and checking in about every 30 seconds to make sure things were ok and to see if PD had arrived yet). We had a light show on the BRP at 2AM with about 10 cop cars: Scarsdale, County, and Eastchester (many of them, without being sent, flew up the parkway). The patient was "restrained" to say the least and we were able to continue to the hospital with a PD car behind us.

In any event, the bottom line: whether expected or not, prepare for the unexpected and ask a cop to follow you. 9/10 times they will offer and rarely will they not. Keeping them in the back may be necessary for some, but remember that they are cops and oftentimes make the patient less cooperative. Have them follow, it's better for the patient, you, and everyone's safety.

[x242Steve 1]

Don't mean to "hijack"...

Can someone tell me what ETOH stands for?

I know its similar to saying "Intox Party"...

Anyone? Anyone? Vinny? Bueller?

[roeems87 0]

Doesn't necessarily stand for something directly... means Ethyl(EDIT) (Et) Alcohol (OH), i.e. the kind you drink. It's just a simple way of saying "drunk" without saying it, because we can't, and the patient doesn't know what you're talking about.

Edited November 18, 2005 by roeems87

[Guest]

Doesn't necessarily stand for something directly... means Ethelene (Et) Alcohol (OH), i.e. the kind you drink. It's just a simple way of saying "drunk" without saying it, because we can't, and the patient doesn't know what you're talking about.

←

Actually its an abbreviation for Ethyl Alcohol (common name) or Ethanol (IUPAC name), its the alcohol that you drink, aka grain alcohol.

Edited November 18, 2005 by JaredHG

[Guest]

Duplicate, sorry.

Edited November 18, 2005 by JaredHG

[Skooter92 7]

Restraining EDPs remains one of the most dangerous things you will EVER have to do, both for you and the patient. Charly Miller has a neat little PDF file at Charly Miller's Homepage about restraints that covers it from A-Z and 0-9.

Read it.

Edited November 18, 2005 by Skooter92

[ny10570 745]

ALl right, so we all agree that havign PD follow and staying on your toes is a MUST. What about some tips for restraining EDP's and protecting ourselves from potentially dangerous patients. WOlf's tip for flipping the straps works great. So does keeping a dialog with the patient. If you can keep them talking you can see their attitude and demeanor change and you are more likely to keep the person from just snapping on you. My best tip is when you're strappign someone in that must be heavily restrained tighten the straps when they exhale. You don't want to restrict their breathing, but it keeps them from being able to get that gap that allows them to wrrigle out of the straps.

[Guest TOYBUFF911]

when you get a call for an emotionally disturbed person do you assume they are violent? what precautions do you take?

personally i have had a few bad experiences with EDP's, 3 days after i got my EMT cert i went on a call for an EDP. it was a 17 yr old male. he wasent acting up at all, and we even carried a good conversation. when we got into the ambulance PD asked me if i wanted a ride along and stupidly i said no. enroute to the hospital the kid pulled a knife on me and almost stabbed me. i was able to restrain him but in the process i broke 2 of his fingers by accident.

now when i get an edp i always take a cop with me, i have him patted down before we get into the ambulance, at the first sign of violence he is restrained and i put a NRB on his face so he cant bite or spit at me.

what do u guys do?

←

WHEN ONLY THE FINEST WILL DO "CALL ESU"

[WAS967 97]

Anyone here dealt with a reported EDP that turned out to be a guy/girl on PCP?

Does that stuff really make them feel/have super-human strength?

Last PCP user I dealt with didn't have the so called super-human strength. Call came in as a person who was "passing out". Family didn't know what was going on with him. Thought maybe he was diabetic. He had periods where he'd go from out cold to wired (waxing and waning delerium). It wasn't until we got to the hospital that his GF revealed he was doing dust.

[Remember585 815]

Anyone here dealt with a reported EDP that turned out to be a guy/girl on PCP?

Does that stuff really make them feel/have super-human strength?

"Drugs are bad, mmm'kay"

←

Yes. It took a half dozen cops, 3 of us EMS guys and a Fire Chief to contain him. Not fun.

[Guest]

I had a 20 y/o male, with some ETOH and possible PCP use (kinda tachy). He was in police custody when we arrived but apparently walked through a plate glass sliding door without feeling it, not to mention trashed the house (picked up items that normal people wouldn't or couldn't, like a coffee table down the stairs).

Restraints?? how about high flow O2?

or maybe a nice sedative brought to you in part by motorola!

[JCESU 20]

Anyone here dealt with a reported EDP that turned out to be a guy/girl on PCP?

Does that stuff really make them feel/have super-human strength?

For the past six months we have averaged about 710 calls for service (per month) of which almost 60% were EDP's. There is no such thing as a non-violent EDP. The name says it all. They are unpredicatble! Most know the system and what they can and can't get away with and they will always remember you if you treat them poorly. Trust me...treat them with dignity they will usually remember that as well. If we are distpatched to an EDP EMS will usually ask us make contact and do the initial assesment and if restraints, body bag, less than lethal means are needed and we will then declare it a "Safe Scene". One of us goes in the bus and the E-Wagon follows directly behind. This way the E-Wagon can see directly into the back of the bus. If need be we will call for another ESU truck or a radio car for the escort. PCP or DIP is probably one of the most dangerous substances out there. They are on a roller coaster from A&O X 3 one second and then you may be trying to restrain them with six guys in the blink of an eye. They have an enormous amount of strenqth but more importantly they have a high threshold for pain. Which is bad for us because even though we are there to get them help sometimes the PT winds up getting hurt in the course of using SOP's re:pain and compliance techniques. Not intentionally but it does happen. My advice, trust no one when they say the PT is non-violent. Not even family members. They will lie to you because they will assume your automatically going to hog tie there loved one. Be on your guard and use the PD as much as you can. If the PD is not available...well all I can say is that an unsafe scene is gonna remain unsafe until the PD renders it safe. Follow your SOP's but more importantly go home the same way you came to work.

Stay Safe,

Rick

[Remember585 815]

One restraining technique that I can think of....

"The Tazer, the tazer, give him the tazer!!!" (Beavis, circa 1998)

[Guest]

when you get a call for an emotionally disturbed person do you assume they are violent? what precautions do you take?

personally i have had a few bad experiences with EDP's, 3 days after i got my EMT cert i went on a call for an EDP. it was a 17 yr old male. he wasent acting up at all, and we even carried a good conversation. when we got into the ambulance PD asked me if i wanted a ride along and stupidly i said no. enroute to the hospital the kid pulled a knife on me and almost stabbed me. i was able to restrain him but in the process i broke 2 of his fingers by accident.

now when i get an edp i always take a cop with me, i have him patted down before we get into the ambulance, at the first sign of violence he is restrained and i put a NRB on his face so he cant bite or spit at me.

what do u guys do?

←

I have been riding an ambulance for some time now. The issue of EDPs has always been an exiting one. Simply put I am called to render medical aid and or transport to a hospital for a patient who wants to go there or by some higher authority than me has ordered them to go to the hospital. In the latter case I am not taking custody of the patient but merely providing transportation for somebody who has taken custody of the patient. There are two rules that are not broken in the back of my ambulance and they have kept me safe from harm for 30 years. Rule 1 if and officer rides in the ambulance with an EDP and me he does not have a Gun or weapon of any kind on his body. Rule 2 if and officer chooses not to ride with me and the patient wants to get out of the ambulance in route or gets violent I pull over at the first opportunity and open the door and let the patient leave of there own volition.

The above obviously does not pertain to transporting a patient with a prescription from a doctor to use humane restraints or chemical restraint. In which case the patient is restrained and sedated prior to me taking custody of the patient in any event.

I am not a police officer. I am not a peace officer. I cannot arrest people for any reason that would be illegal. I am a school teacher or a house wife or a stock broker and I volunteer my time on an ambulance that’s all and I have no special super powers because of it. If the patient does not want me treating or transporting him I cant do anything. How much simpler can it get?

[JCESU 20]

One restraining technique that I can think of....

"The Tazer, the tazer, give him the tazer!!!"  (Beavis, circa 1998)

←

or Ketaset........at least you don't have to get so close..

[WAS967 97]

Rule 1 if and officer rides in the ambulance with an EDP and me he does not have a Gun or weapon of any kind on his body.

How do you go about getting the officer to relinquish his/her weapon(s)? Most officers I know would opt not to go with the patient than to go weaponless. Perhaps some of the law officers on here could provide some feedback on this?

Rule 2 if and officer chooses not to ride with me and the patient wants to get out of the ambulance in route or gets violent I pull over at the first opportunity and open the door and let the patient leave of there own volition.

Smart move. We had this debate at work once before and it boiled down to this. We as EMTs are not trained to properly restrain patients. How many agencies have P&Ps regarding restraining uncooperative patients? None that I know of. (I'd like to see some if anyone knows otherwise).

I am not a police officer. I am not a peace officer. I cannot arrest people for any reason that would be illegal. I am a school teacher or a house wife or a stock broker and I volunteer my time on an ambulance that’s all and I have no special super powers because of it. If the patient does not want me treating or transporting him I cant do anything. How much simpler can it get?

It doesn't get simpler unfortunatly, but rather, more complex. You can do something, in fact, in a lot of case we HAVE to do something. If you are called to deal with a patient that does not want to go (anywhere), and you suspect that the patient may be a danger to self or others, you are obligated to see that patient is seen to treatment. If you have to call PD then by all means, get them involved. IF they have to arrest the patient and toss them into a patrol car in 4points and transport them to an acute psych center that way, then so be it. At least they are going to be cared for.

Edited December 3, 2005 by WAS967

[Guest mediclawyer]

seat belt on the bench and lock the back door for most. cravats (drape over hand with half on each side, reach down with hand and hold both sides, and pull loop down to create slip knot. put hand through slip knot, grab patient's hand and slip over their wrist. tie to stretcher- this tightens when they pull, but is comfortable when they are not). I rarely need police- taking care of sick people is my job, not theirs.

[Guest]

You rarely need police?No offence but every EDP I have ever delt with has NEVER just let me restrain them.If a person is out of control,Johnny Law needs to control them. Taking care of violent people is their job not mine.They are trained in proper take down and control/ custody of combative persons.Remember: Your safety, Crew safety, Pt safety, in that order!

[roeems87 0]

This is an incredibly simple arguement. I don't see what the problem is here. Emotionally disturbed people have medical problems, that is why it is our job to take care of them and to get them to a hospital or appropriate facility to get more definite care. Our job is to deal with sick people in safe scene situations. If the patient himself/herself is the danger, then that must be contained through the entire call. Meaning if the patient has the potential to be a problem (or is a problem) then you need police to be with you. That's their job--to keep it safe. So we're working together, not separately. It's really not that difficult to comprehend... You would never, ever, have a patient in the back of the ambulance with a knife... would you? That's the same potential... even if they themselves are the weapon, they are a DANGER. If you want to say that you never need police, you will get killed or hurt by someone one day. I have never had someone allow me to restrain them. Many people have problems with you tying their hands down so they don't reach while in the stairchair (and they don't have some mental issue to deal with at the moment). What makes you think they're going to let you tie them down in the ambulance? More so if they have some neuro or psychological problem...

Edited December 7, 2005 by roeems87

[Guest]

here is a simple technique grab them by ther necks and choke them if they come within 5 ft of harming yoursef

[E64PCFD2044 1]

here is a simple technique grab them by ther necks and choke them  if they come within 5 ft of harming yoursef

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Nahh...that's just how to deal with you!!!

[Guest]

Nahh...that's just how to deal with you!!!

←

yea we know your technique dump trucks hahahaha lolgotchaaaaaaaaaaaaaa

[210 91]

I have been riding an ambulance for some time now. The issue of EDPs has always been an exiting one.  Simply put I am called to render medical aid and or transport to a hospital for a patient who wants to go there or by some higher authority than me has ordered them to go to the hospital.  In the latter case I am not taking custody of the patient but merely providing transportation for somebody who has taken custody of the patient.  There are two rules that are not broken in the back of my ambulance and they have kept me safe from harm for 30 years.  Rule 1 if and officer rides in the ambulance with an EDP and me he does not have a Gun or weapon of any kind on his body.  Rule 2 if and officer chooses not to ride with me and the patient wants to get out of the ambulance in route or gets violent I pull over at the first opportunity and open the door and let the patient leave of there own volition.

The above obviously does not pertain to transporting a patient with a prescription from a doctor to use humane restraints or chemical restraint.  In which case the patient is restrained and sedated prior to me taking custody of the patient in any event.

I am not a police officer. I am not a peace officer.  I cannot arrest people for any reason that would be illegal.  I am a school teacher or a house wife or a stock broker and I  volunteer my time on an ambulance that’s all and I have no special super powers because of it.  If the patient does not want me treating or transporting him I cant do anything.  How much simpler can it get?

←

I know this is an old thread but:

If you find a police officer willing to give up his/her weapon(s) to include firearm, pepper spray, Taser, ASP baton, etc. let me know I'd love to read their PD's SOP's. I have been in law enforcement for years and have never entertained the thought of giving up my tools of the trade for any reason. Nor have I have ever worked with or been associated with another officer that would. Rule #1: Never surrender your weapon.

If you want the officer to give up those tools why would you call for PD assistance to begin with? If something goes wrong and the officer has to defend himself or you we have a problem. Take down techniques are fine but EDPs can be quite strong.

My two cents.