Versed fail, I need a trainquIlizer gun

[stcommodore]

So on several occasions I have a combative patients that require chemical sedation. Our protocol says that patients that "struggle against" hard restraints should be sedated. Now my only option sometimes is to sedate to restrain, or restrain, sedate and wait. I personally feel when your fighting a 200lb drunk who barricaded himself in his car waiting 15-30min for IM versed to work sucks. I guess the only option is to give up IM/IN and fight for the IV? I don't lightly throw narcs at people but I don't fight them either.

[DartmouthDave]

Hello,

If the fellow is a wild man I think (despite the wait) the IM/IN would be a better options than fighting for an IV. Get the IV once he has settled for a follow up dose if needed. Better than getting a stuck while fighting with an angry drunk. IMHO.

Cheers

[medicgirl05]

Our protocols don't allow for sedation of combative patients. If it is a head injury we can restrain them and once I called medical control for sedation options and was approved to give Valium. My question is why are you sedating a 200lb drunk? Where I work if the drunk is able to put up a good fight then they are stable enought to go to the ER in a patrol car. Ive also had OD's that have been extremely combative but in that case the Sheriff deputy accompanies us to the ER and the restraining is done with handcuffs. Maybe its just a difference of where we work but I dont plan on fighting a drunk to sedate him. Im not saying its wrong just asking why endanger yourself or your partner?

[AnthonyM83]

Here you would go right back to good old fasioned call-for-PD.

Versed via intranasal might be useful in these cases.

[Kiwiology]

Could always give him a very large dose of ketamine and send him into orbit

[Richard B the EMT]

If any patient is violently combative, drunk or otherwise, then I have a question: How is an EMSer to get near enough, without risk of their person, to administer any tranquilizer? Which one of us mice is going to put the bell on that darned cat's collar?

I am only halfway joking. It is a good question, to which I, at least, don't have a workable answer.

[HERBIE1]

If any patient is violently combative, drunk or otherwise, then I have a question: How is an EMSer to get near enough, without risk of their person, to administer any tranquilizer? Which one of us mice is going to put the bell on that darned cat's collar?

I am only halfway joking. It is a good question, to which I, at least, don't have a workable answer.

Police, Richard. I don't fight with these idiots- unless I or my partner is in danger. (We also are not allowed to chemically restrain anyone.)

If they suddenly decide they want to trash the rig- fine. I'm outta there. I'll wait outside until the boys in blue show up with Tasers, cuffs, and guns. I'll fill out the paperwork later. Now I realize our brothers and sisters who work in rural areas may not have the option of a rapid police back up, but at the end of the day, we are all supposed to go home in one piece.

[DwayneEMTP]

Yeah brother, maybe you just pulled the drunk out of the air, but as said by my betters, you really shouldn't be screwing with that guy when he is that lucid. But if you must, the correct treatment sequence would be, tazer, IN Versed (or whatever), more IN Versed, then an IV if you feel there is still a need.

Now I, as well as a few others here I'm guessing, am not going to pretend that I've not crawled into the back of the truck with a mean drunk on occasion when I'm feeling a little bit froggy. I'm also not going to admit that I have. But if I had that would be very unprofessional, dangerous to myself and my family's financial security, open myself up to a multitude of moral/ethical/legal issues and set a very bad example for anyone stupid enough to do such a thing when other, more responsible options exist. And it was likely so that I could give him a shot of IN Versed. If it happened at all. Which it probably didn't. Just sayin'..

And, in case you didn't pull this guy out of the air, why WERE you dinking around with a 200lb drunk that had himself barricaded inside of his car? Suicide or some such? Either way, still a cop issue, I'm just curious.

Dwayne

Edited to correct a spelling error. No other changes.

Edited December 17, 2010 by DwayneEMTP

[stcommodore]

He flipped his car on a road ballard, wasn't entrapped or physically hurt but wouldnt come out. I fought against tasing him, ended up using police muscle to get him onto the board and into the truck. Tried the versed in the car to calm the beast, and again in the truck w little luck.

[medicgirl05]

Just for my curiosity...why fight tasing him? I've seen a few combative patients tased and it seems like a real attitude changer to me. Though I've only seen a few I understand that tasing rarely results in any detriment to the patient???