Defend partner and self, get sacked?

[Dustdevil]

Is it just me, or is anyone else sick of the term "EMT Worker"?

http://www.madisonrecord.com/news/224299-emt-worker-claims-he-was-wrongfully-fired-after-punching-patient

• EMT worker claims he was wrongfully fired after punching patient
  1/25/2010 10:12 AM By Kelly Holleran
  
  A former emergency medical technician has filed suit against his former employer, claiming he was wrongfully fired after he punched a patient in an attempt to calm him.
  
  Jonathan Hayes claims he lost his job at defendant Mission Care of Illinois doing business as Abbott EMS after attempting to medically treat a large patient who was suffering from a seizure on Jan. 17, 2008.
  
  The patient became combative, so Hayes called for police assistance and another ambulance unit, according to the complaint filed Jan. 15 in St. Clair County Circuit Court.
  
  Eventually, the patient was placed on a stretcher, but that did not subdue him, the suit states.
  
  "Patient became even more combative, placing himself in harm's way and striking his partner causing him to become dazed," the complaint says. "Even after being touch stunned, patient started striking Plaintiff's supervisor, punching Plaintiff in ribs, and striking his partner."
  
  Several police and EMT attempts to calm the patient were unsuccessful, Hayes claims.
  
  "Plaintiff was required to use force in an attempt to protect himself and his patient from further harm, thus he punched the patient," the suit states. "Plaintiff was wrongfully terminated as for his use of force in his attempt to calm the extremely combative patient who was not responding to police stun guns and drugs."
  
  Because of his termination, Hayes has suffered a loss of hourly wages, health insurance, benefits and seniority, according to the complaint.
  
  Hayes is seeking a judgment of more than $50,000.
  
  He will be represented by Morgan Scroggins of Scroggins Law Office in Granite City.
  
  St. Clair County Circuit Court case number: 10-L-20.

Edited January 27, 2010 by Dustdevil

[FireMedic65]

Although I am also getting sick of hearing "EMT Worker" as a reference to what I do, it is better than "EMS Professional". Yes, I do consider myself a professional, but I do not consider others whom are on the same level. Professionalism is a term you should earn, not apply for.

Anyway, since I was not there, I do not know how things unfolded. Protecting yourself and your crew has always been a first priority. "Hitting" a patient should never be done, but I suppose in extreme circumstances, it might be warranted. With having police on scene, your job should be done for controlling that patient though. At that point you would just assist them.

Getting fired for these circumstances as explained in the article, do not seem like the most appropriate choice. If it were up to me, I would have suspended them and had them attend a self defense course on how to properly restrain a patient, or learn the art of egress.

[Happiness]

Well I must say I personally dont calm down after I've been punched

[FireMedic65]

Well I must say I personally dont calm down after I've been punched

Maybe you need to be hit harder jk jk

[JakeEMTP]

While not being there and admittedly unfamiliar with Abbott EMS, I would consider using restraints and possibly chemical sedation prior to getting into a physical confrontation with a pt. I've had seizure pt's before who have been combative. That is why we have standing orders for 2mg Valium IV or 5mg Versed IM if IV can not be established (we can give Versed IV also, but stated IM prior to the expected feedback). I know the article says the pt. wasn't responding to chemical sedation. I have found that securing the pt. with cloth restraint's ( although I don't know how effective they would have been with this pt.) or those ziplock handcuff thingys the cops have to secure the pt. to a backboard have been effective.

I won't stand in judgment of the EMS provider in the article. I'm just saying there may have been other methods of restraint before fighting with the pt., especially with LEO's on scene.

Edited January 27, 2010 by JakeEMTP

[fireflymedic]

I'm like Jim, I'm not going to judge as I wasn't there and I don't know what their protocols will or will not allow. I've been in the situation of having a patient considerably larger than me attempting to beat me up and it wasn't pretty. Didn't have the luxury of meds to give (basic at the time with basic partner) and pd was nowhere to be found. Yep we did some unconventional things to take control of the scene, but we had to. I certainly don't promote that, but if that's your only option, so be it.

Now - the flip side. One I'm wondering if the reporting is accurate (like it ever is but.... ) because I've dealt with many a seizure patient, and yes, they will become combative post ictal (or ictal if complex partials), but the aggression is usually not directed - this sounds pretty directed to me. Most of the time it's because you won't let them up and they become restless trying to fight to get up or you are blocking their path if they are wandering. I have yet (not to say it doesn't happen, but not yet to me at least) to have one intentionally hit me, and then continue to do so. Obviously yeah, I've been in the way of a swing or struggle to get up more than once, but not intentionally. Also - alot of times if you de-escalate the situation, make it more quiet and relaxed they will as well because they are simply disoriented (think about how people are when they first wake up - not totally with it and fuzzed - well that's the feeling). Should restraints have been utilized - yeah - perhaps wrist and lap restraints in addition to normal stretcher straps would have been considerably more beneficial than taking a swing. That likely only made things worse. All else fails, there are such things as backboards and spider straps (or backboards and restraints). Would have been much easier to justify and get out of hot water with the department and also the state than taking a swing. At a minimum people - you were in Chicago ! You can spit and hit a cop ! Let them be the ones to get in trouble dealing with a combative patient, not you. Protect yourself, protect your cert and if all else fails, let the guys with the guns be responsible for restraint. It can always be sorted out later. Also, this doesn't say whether meds were within range, but for a seizure patient, I think one could easily justify giving valium, versed, or ativan (versed and ativan IM) for sedation. I know many have bent the rules on combative seizure patients and utilized this with justification with no backlash.

Be safe, be smart, be wise out there.

Edited January 27, 2010 by fireflymedic

[Dustdevil]

While not being there and admittedly unfamiliar with Abbott EMS, I would consider using restraints and possibly chemical sedation prior to getting into a physical confrontation with a pt.

According to the article, chemical sedation had failed.

If it were up to me, I would have suspended them and had them attend a self defense course on how to properly restrain a patient, or learn the art of egress.

While I think you are on the right track, I would submit that even suspension would be inappropriate. It's not quite kosher to punish someone for not doing something you never taught them to do in the first place. By sending them for a self-defence course, you are admitting that you have failed to provide that in the past, which puts the culpability straight back on you as an employer. And then what about the next guy? Are you going to send this one employee to a special course, but not all the rest? And was documented proficiency in self-defence a condition of employment to begin with? You can't change the rules and enforce them retroactively.

This seems like a clear cut case of managerial and administrative FAILURE. The problem exists and manifested itself because of incompetent management, and even worse, they're trying to shirk responsibility by sacking the low man on the scrotum pole.

[FireMedic65]

I feel that everyone in EMS should have some training in self defense. Even though you aren't supposed to enter a scene that could be violent and you should leave if things become bad. Sometimes, you don't have a choice.

That's neither here not there though in this case. The approach they took on "restraining" this patient was pretty terrible. You had PD on scene, let them take care of it and help. Then again, cops usually start throwing fists as a first attempt in restraining a person...