Restraining patients

[Jeep_911]

O2 tank at the back of the head.......

[windsong]

Try post it notes, stick them on them and say your a complicated pt.

[Spock]

We are not allowed to restrain any patient unless we get an order from medical command. Our command docs are petty good about authorizing chemical restraints and we use versed. Our police can restrain any patient they feel is violent and they do not hesitate to use the cuffs. They also transport with us if they cuff the patient. We have police responding to almost all of our calls. The police chief feels this is good PR for his department and the officers are usually very helpful even on simple calls.

In the hospital, leather restraints can be used only on the order of a physician and security places the leathers. Soft restraints can be used in the ICU but again only on a physician order which must be written every 24 hours. I think this is a JCAHO requirement.

Live long and prosper.

Spock

[ffpm41]

1) Show of force (Fire and LE) with verbal "talk down" (that always works).

2) Restraints.

3) Chemical restraint, Versed, Ativan or Inapsine. I like Versed IM, not much luck with Ativan, and never used Inapsine due to possible cardiac effects.

If the coppers handcuff them, they have to ride with us. Our MPD has is liberal with chemical restraint so there is less risk of us getting hurt or the patient.

No hog-tying, backboard sandwich, choke holds or use of hand/flex cuffs by EMS.

After all is said and done we have to fill out a form for QA/QI.

[Arachne]

We use PD if at all possible...If nothing else, they have more restraint training and are paid a lot more than we are, so they may as well wrestle patients if they're there. Both places I work will happily even let me take PD in my truck to the hospital, which I've found helpful. If PD is not on-scene and the patient is not actively fighting us, I'll wait for PD. I'm small, I try to stay out of fights.

For transport purposes, I personally like cravats, with one arm down, one arm up. We carry soft restraints, but they are cumbersome to use and if your patient is actively fighting you, there's no way you're going to get them on. I'm also a fan of backboards - not backboard sandwiches, but just regular backboarding with straps properly cinched and hands restrained with cravats. It also makes them highly portable - you don't have to remove restraints to give them to the hospital.

[Ridryder 911]

Here s a new way I found works!.. When P.D. is about to leave them with you.. yell out they have a GUN!!!.. oops!:shock:

R/r 911

[tinman694]

The gun thing is cool....I used to be a cop --

In the past two weeks have had a couple who have had to be restrained---one was having a full blown MI and actually put up a good fight for about 1 min---we had PD to 'help out'

Usually it is crack heads--oops Pharmaceutic-ally gifted--who present the most problems--we have had a rash of 'bad' cases where the pt. exhibits psychotic behavior to the point of mania (go figure)

Problem was we had one (Gifted Person) who was restrained (with posey restraints--the cloth ones) who punched my partner, two cops and kicked me.all while spraying blood from numerous small cuts on her arms and legs..we got her under control (had orders for Valium and restraints...only got the restraints on) when we got her to the recieving hospital, the nurse INSISTED we remove the restraints immediately-- gave a pt. report, got a signature--and we left--the pt. walked out of the ED about 2 min. after us--right past the ambulance we were decon....

The security weenies yelled at us as to why we didn't stop her or go after her---

[Lone Star]

The gun thing is cool....I used to be a cop --

In the past two weeks have had a couple who have had to be restrained---one was having a full blown MI and actually put up a good fight for about 1 min---we had PD to 'help out'

Usually it is crack heads--oops Pharmaceutic-ally gifted--who present the most problems--we have had a rash of 'bad' cases where the pt. exhibits psychotic behavior to the point of mania (go figure)

Problem was we had one (Gifted Person) who was restrained (with posey restraints--the cloth ones) who punched my partner, two cops and kicked me.all while spraying blood from numerous small cuts on her arms and legs..we got her under control (had orders for Valium and restraints...only got the restraints on) when we got her to the recieving hospital, the nurse INSISTED we remove the restraints immediately-- gave a pt. report, got a signature--and we left--the pt. walked out of the ED about 2 min. after us--right past the ambulance we were decon....

The security weenies yelled at us as to why we didn't stop her or go after her---

Under Michigan State protocols, once patient care has been effectively transferred to the recieving facility, the responsibility of chasing down a 'runner' ( as in this case), rests SQUARELY on the reciveing facilities staff. We're EMS personnel, not security, or law enforcement.

As far as the 'Pharmaceutic-ally gifted'......ahh yes, better life through chemical enhancement. I just wish they didn't enjoy the 'enhancement' quite so much!

[Aleks]

Ours are pretty lame.....Soft restraints (triangulars, or we also have commercial posy/velcro-canvas restraints on all stretchers), spit hood, Haldol IM (in absense of contraindications), Versed IM/IV......we also have liberal prehospital self defense training, so we can use all human submission techniques too....It was much better when we used to be able to mix droperidol/versed, but some genius decided drop&drool kills....

[Asysin2leads]

Allowed to assist law enforcement ONLY. Of course, with the hit and miss PD response we have, and with some of the people they are allowing on the force, we end up doing the grunt work anyway. If things really get out of hand, we call in ESU who has a really neat restraint full body thing which works just dandy. Usually I try and follow the general "continuum of force", starting with authorative presence and ending with rolling on the floor with the cravats and or calling in ESU.