Just_Smilin_Man Posted October 29, 2006 Posted October 29, 2006 I have been reading posts here for about two months and have never seen the need to register an account. I have never had the urge to post. I normally just read and agree, disagree, or laugh at the posts. I thought I might find it enlightening to read other peoples point of views in our career path. Here is what I have gotten from the posts on the site,(and this thread is very similar to all others ). Im starting to notice quite a trend...... I am so glad that this site has people like Dustdevil, NSMedic, and RidRyder! If it werent for these people your site that you all like to post on would be full of threads that would contain the following.... 1. Subject, 2. Statement or question by poster, 3. Replies to post by other fellow site dwellers that may be enlightening or may not, but since we you all have the aforementioned posters on the site we can all rest assured that they will clog threads with with no offering of feedback to the original poster( which is who the thread was created by obviously), but are chock full of reasons why everyone else is a bonehead, and they are ofcourse right, again. I have gained so much insight by these posts of slander, condescension, and outright self-indulgence. Being so self-centered that you lose all sight of the original topic and take the opportunity to slam other people that are trying to give the original topic starter feedback is very irresponsible and childish of supposedly well trained and well versed Medics. Come on people. You have a good sight here! Quit clogging your own threads w/ irrelevant squabling and character void demeaning posts! To the members that seldom add relevant input to posts, but always have time to tell someone how ignorant they are....this is a community, not dustdevil.com, or nsmedic.com, or ridryder.com or whatever. You know who you are if you fall into this category. Please cut people some slack. Keep in mind the following..........In a clinical study of mice in mazes, the mice in a starting point surrounded by mirrors became so enthrawled with themselves that they lost sight of the purpose. Sorry for using your thread, but tis one was full of rediculous, pointless " slamming", and name calling. Take care all!
chaser Posted October 29, 2006 Posted October 29, 2006 I have been reading posts here for about two months and have never seen the need to register an account. I have never had the urge to post. I normally just read and agree, disagree, or laugh at the posts. I thought I might find it enlightening to read other peoples point of views in our career path. ..........In a clinical study of mice in mazes, the mice in a starting point surrounded by mirrors became so enthrawled with themselves that they lost sight of the purpose. Sorry for using your thread, but tis one was full of rediculous, pointless " slamming", and name calling. Take care all! Ok "just smiling man"- what was the trigger for you to post now? Something apparently set you off.
medic001918 Posted October 29, 2006 Posted October 29, 2006 NREMT-Basic wrote: "We were taught way back at the beginning of EMT school how to interact with patients..." Yes, what I was taught was any potentially violent patients, call the police....they'll transport them. What were you taught regarding psych patients? Something different? If you guys are being made to transport violent psych patients, remind me to never go to work for your service. Have you ever been physically attacked by a violent psych patient in the back of your truck? I had my glasses broken and a laceration stitched closed under my left eye a number of years ago by a supposedly "calm" lady that I was transporting. I take no chances anymore with psych patients, if they're gonna freak out with me, they're either going in the back of a police cruiser, or a police officer is coming in the back of the ambulance with me, and they're cuffing the patient to my stretcher. We don't even have proper restraints in our ambulances here in Nova Scotia. If I want to restrain a patient who becomes violent on me, I have to use triangular bandages and/or duct tape to tie their hands to the stretcher, all while they're fighting me. Think it's easy doing that by yourself? You try it. I'd much rather let the police transport these folks. I, as an ACP, am also allowed giving 5mg IM versed to violent patients, in an attempt to sedate them enough to calm down. Again, ever try drawing up your med with a syringe/needle while a patient is fighting you? Then you come towards them with the needle and syringe in order to give them the shot, and if they're not ballistic enough, you're gonna make them even worse, because the last thing they want is to be calmed down. Believe me when I say, it's not so easy!!! I remember an incident a few years back that happened in Halifax, where an ambulance was transporting a psych patient between facilities. The patient had been "sedated", supposedly with enough medication to snow a goat....he was quietly "sleeping" on the stretcher at the hospital when the ambulance arrived. Enroute to the receiving facility, the patient suddenly "woke up" (I really don't think he was properly sedated to begin with, but that's just my opinion), and grabbed the attending medic by the throat, and began choking him. The medic who was driving screamed at the patient, promptly alerted dispatch as to what was going on, and managed to pull the ambulance over to the side of the road in order to try and help his partner. By this time, the medic in the back who was being choked, his lips were cyanotic. Then the police arrived....luckily, no lasting damage to the attending medic. This could have had a much worse outcome, except for the fact that the police were right around the corner. But such isn't always the case. I don't advocate EMS never treating psych patients, all I'm saying is, USE COMMON SENSE, for God's sake! Sure, I love my job, but I'm not going to risk my life in order to save somebody else's.....I won't be around too long if I start doing that on a regular basis. I find a couple of things very interesting about your post. The first of which it sounds like you're writing your post to a group of people who has never dealt with violent patients in the past. I think most, if not all of us on this board that actively work in EMS have dealt with violent patient. It doesn't matter if you like it or not, they are a part of the job and often need to be transported just as much as the patient that's sick. A police officer (at least in my area) won't transport a psych patient because if they go to jail and then are found to have a medical cause and not a psychological one (think of a combative diabetic for example or head injury after a car accident/assault/fall), then the police department has just welcomed a rather large liability. In today's litigation motivated society, the police officers would rather have someone go to the hospital to rule out any cause of the event and then charge them after they are medically cleared. Plus I'm sure you've heard of cases of the police department getting into trouble over a psych patient that they restrained dieing from positional asphyxia? No police department wants to go through the legal troubles that come with that and ambulances are how patients get to the hospital so that they have someone with medical training properly montioring them to ensure that this is not the out come. Maybe the EMS programs in Canada are different with regard to their treatment of psych patients, but the police departments here won't transport them. They will sometimes transport with you (depending on where you are and where you are going), or they will follow behind. We have the same triangular bandages that you use for restraint and when used properly actually make a very effective restraint. As a paramedic, we have the option of using 2mg Ativan and 5mg of Haldol for chemical restraint. This tends to be an effective means of sedating most patients. And we always have the option of calling medical control for repeat orders. So in your post as you mentioned to try restraining a combative patient with same means that you use, I have done so frequently. While fighting with someone in the back of your ambulance is less than ideal, if you perceive a threat or see tensions rising during transport ask your partner to stop and call for help and to assist you in restraining the patient. Utilitze your tools and think ahead. Any person has the potential to be violent. This is everyone from a child to the elderly. And you never know what might set someone off into a rage. If you think there is a solid chance the patient could become out of control, have members on scene (other EMS providers or PD) assist you in restraining the patient prior to transport. I've restrained people as a preventative measure before. While I can appreicate your story about the medic who was choked by the supposedly sleeping patient, how was the hospital to know that the patient was or wasn't truely sedated? And as quickly as that patient turned violent without warning, do you know what lies on the other side of every door you knock on while at work? You never know what you're walking into, so the potential for a call to get violent exists on every call. Working in a city that is consistently ranked in the nations top 10 for violence and where getting a police officer to your scene is not always an easy task, you learn to adapt and overcome and you become better at reading people's behaviors. I've dealt with my share of violent patients, and while they are often difficult cases to manage they are not impossible and the police department should not always be the ones transporting these patients. If you're concerned for how to physically handle a violent patient, I would suggest taking some self defense courses. You'll learn how to manipulate people to your advantage physically and you'll learn how to read their actions and have better insight as to when a patient (or anyone) is going to take a swing. There are countless control holds that take little effort to apply but that are highly effective at controling someone. Maybe after taking some classes you (or anyone else) would feel more comfortable handling a violent patient (or person in general)? Shane NREMT-P
DwayneEMTP Posted October 29, 2006 Posted October 29, 2006 I have been reading posts here for about two months and have never seen the need to register an account. I have never had the urge to post. I normally just read and agree, disagree, or laugh at the posts. I thought I might find it enlightening to read other peoples point of views in our career path. Here is what I have gotten from the posts on the site,(and this thread is very similar to all others ). Im starting to notice quite a trend...... I am so glad that this site has people like Dustdevil, NSMedic, and RidRyder! If it werent for these people your site that you all like to post on would be full of threads that would contain the following.... 1. Subject, 2. Statement or question by poster, 3. Replies to post by other fellow site dwellers that may be enlightening or may not,but since we you all have the aforementioned posters on the site we can all rest assured that they will clog threads with with no offering of feedback to the original poster( which is who the thread was created by obviously), but are chock full of reasons why everyone else is a bonehead, and they are ofcourse right, again I'm sorry you are so far unable to see passed that point of view. If you had visited many other sites you would see many/most threads are filled with the following (exagerated, but not by much): Medic: "Man, had to pick up a gomer at the NH that fell out of bed...ER doc went ballistic because he didn't have oxygen or spinal precautions!! As$hole!" Poster 1: "Yeah man, I fel yur pane! They shuld ride in the bus onse or twise and they wuld see what we half to put up with!" Medic: "And the dum nurses wouldt even back me up!" Poster 1: "Hel..They half a lttle colleg and think thy now everything!" Followed by post after post of people "feeling his pain". When the most benificial thing, thus kindest thing, someone could say to them is "Stop what you're doing, right now, and choose to discontinue being ignorant!" Thanks to Dust and others, it is a little scary here to post here foolishly (and I don't feel posters in this thread were foolish). And I like that. It's unfortunate that you make a point of saying that you benefit from this site without contributing....and yet your one contribution (should it be called that?) is to take a shot at the very people that help keep this site worth visiting. (I'm assuming you agree it's worth visiting as you've been coming for a couple of months). It is uncommon to find a question posted here with replys that don't force you to think, or take a pretty hard look at your educational background. The feeling seems to be that most issues became issues because the necessary knowledge was not in place to resolve them. Pointing this out is not self centered, it is a realistic step in helping the posters further their patient care, job satisfaction, and career. I hope you stick around....It would be great to learn what you have to teach. Though, as you've pointed out, if your unsure of your education or professionalism or are unwilling to trade a little critisizm for a little knowledge, perhaps it's best if you just continue to watch. Have a great day! Dwayne Edited to add to part of a quote for context. Sheesh, and spelling.
becksdad Posted October 29, 2006 Posted October 29, 2006 Just_smilin_man, I am a fairly new member of this community myself, and I have to tell you that there are quite a few members here that I have come to admire and respect (those posters you named individually are all among them). Whether I always like the way some things are presented is irrelevant; I always learn something of value from this site, and in a way, I view many people here as mentors. As an example, I would point to this particular thread that you take such exception with. Sure, the posts migrated away from the original topic, but I tend to view this more as an evolution than a migration. This particular evolution ended up being an instruction (for me) in O2 administration principles beyond what I currently knew. So I tend to go with the flow, see where things go, and usually end up learning something. Like Dwayne, I invite you to stay and view the site with an open mind, and impart your own knowledge. There are more than a few here who initially had some reservations, but are now staunch supporters. Hope to see you around the site!!
becksdad Posted October 30, 2006 Posted October 30, 2006 Ooops! Wrong thread! Hey, they're all good!!
Shelbmedic Posted November 9, 2006 Posted November 9, 2006 In response to Psych pt's I have been in this job for 18yrs ++++. Medic53226 I'm not picking on you but I was taught that there is no such thing as a routine call and that all the pt's I pick up get checked out from head to toe before they are not transferred by me. It might take the extra min on scene but there are times when that extra min makes a BIG difference in the Pt.s life. I have had the calls for the little old lady who called because she is felling Stressed only find that she was not violent, but just need to talk to some one about the recent death of her husband and to find out that she had not been taking care of herself for the last 2 weeks no meds very little food intake. done a set of vitals C/S reading high B/P was 210/110 H/R was 88 reg and strong. she had no C/O other than feeling stressed placed her on the monitor NSR that went to uncontrolled A-fib to a-flutter with a 4:1 Block. We transported her code1lightand siren approx 10min drive. Later on she threw a clot in the ER and pasted away. My point is that my partner who is a 24yr vet said OH my GOD here we go again another Taxi run because she is stressed Why doesn't she call the taxi. So my point is if the pt is Violent then either have the PD transport or have them cuffed and PD go with you. But never assume that because they are stressed that it is not medical related until proven other wise.
Redcell19512 Posted November 9, 2006 Posted November 9, 2006 I can understand why EMS providers feel psych patient's are a waste of time. It seems like it's a never ending cycle. How many of you have transported the same psych patients for the same problems over and over again. You take them to the ER, a week later you see them again on a 911 call. They never seem to get better. The patients that OD do it on their psych meds. Kinda ironic. I work regularly with an EMT who's wife is a psych/social worker for one of the local hospitals. Through her we have learned a lot about how to deal with psych patients. Our attitude toward them has changed. What would you rather do at 2 am, work a code or sit and talk with a 40 yof who is depressed about life. If you spend a few mintues and listen to their complaints and acknowledge their suffering, some times it makes the patient feel just a little better. Gives you a kinda warm fuzzy feeling. You've helped someone feel just a little better. I still have an issue with violent criminals being transported in an ambulance just because they have been drinking or claim to be suicidal. The police transport DUIs without EMS intervention all the time. Not saying that's right, just saying that there's no consistency. So why do we see these same psych patient's over and over again? Part of the problem might be the fact that they are not recieving proper treatment. Psych patient's get no real treatment in the emergency room. Suicidal subjects get no real treatment during an inpatient psych admission.
medic53226 Posted November 22, 2006 Author Posted November 22, 2006 Shelbmedic, I thank you for your comments and I was not trying to say that the pt wasn't worth my time, and that I would check he out I had a new intermediate and that had had many runs since in our system medics take 90% of the run. The pt had no distress, and was AOX3, was evaluated by me before I got out of the ambulance and answer all my questions that I asked and at the present time of the run, I felt she had alot of issues, and that it would be a good run for him to learn on, and I at no time felt she needed monitor, with her intial assesment, because all of her vitals signs was stable and no distress, nothing, and also I don't consider ambulance runs taxi rides, I take pride in my work and I treat everyone with care and compassion, and as you said not to quote, and won't I check all my pts before anyone touchs them.
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