violent psych patients

[EMS828]

Should we as EMS providers transport violent psych patients to appropriate facilities, or should that be left to the Police. I have transported with chemical restraints but that does not always work. i mean your in a small area and if the patient decides to get violent there is no where to go, except protect yourself. any thoughts or feelings............................... i feel if they are violent they should go by Police.....................

[JPINFV]

Psychiatric disorders are a medical problem, and thus should warrant transport by medical providers and not law enforcement. To this end, EMS education [especially at the basic level] should consist of more then the "back away, call police" mentality. While I have no problem with law enforcement being involved with psych patients [holds, initial restraint, etc], I would prefer that they go by ambulance instead of by police car.

[akflightmedic]

One service I worked for had a transport vehicle for psych patients going from hospital to psych ward. It was a station wagon that had the back partitioned off like a LE vehicle.

That way, they were escorted to the back seat, where they were harmless for the trip and then upon arrival at recieving facility, the welcoming committee came out to assist unloading if needed.

[EMS828]

we had a tahoe with partition and medicare quit paying for transports its back to using ambulances like i said no safety for ems personel................

[Just Plain Ruff]

psych patients should be transported by EMS but in no way should you compromise your safety. They are patient's and deserve to be treated like patients but if my safety or my partners is in question then restraints should be mandatory not elective.

The question I usually ask the transferring facility, "Can you come with us, he seems to like you?"

when they say "no he's too dangerous" then I say "Please write an order or approve restraints. If he's too dangerous for you to go with us then he's too dangerous to go without restraints"

Usually that gets us restraints.

[Ridryder 911]

Majority of our psych patients are transported by LEO as they should be. Unless one is going to sedate or administer psychotropic medications, why should an EMS unit be tied up for just transporting from one facility to another. As well, in my state only "Peace Officers" can legally formally place one under an "Emergency Order of Detention"; (Pysch evaluation/ 48 hrs).

None of the EMS, I am aware of have specialty transport units, rather than local police units. There are some LEO specially trained in the metro areas, that have "Psych Techs" that are LEO/EMT and have attended speciality training. They patrol the local hang outs know for those with pysch problems in a "special bus" and transport them to the Crisis Intervention or Psychiatric Hospital.

R/r 911

[katbemeEMT-B]

Our service transports psych patients often. If it happens to be a violent patient, we will use whatever restraints necessary, (physical, chemical sedation, or both). If there are any questions as to our safety, we bring LEO with us.

[Dustdevil]

If there are any questions as to our safety, we bring LEO with us.

What psychiatric education do you have that enables you to reliably determine if there are any questions as to your safety or not? Seriously, how do you know until it happens?

There are always questions as to your safety. Complacency kills.

[FormerEMSLT297]

I'll give you one better, how do you know that they are "psych" patients??? they might be overdosed, hypoglycemic, or any number of other metabolic disorders that cause an altered mental state. What about "excited delirium", ? etc.

The truth is you can't know until you have some tests done. All Psych patients should be transported by an EMs unit with police accompanying.

You can do basic tests like blood glucose, and in some places there are chemical restatint policies.

As for them getting violent in the back of your unit... I remember it happening, if they are not restained ,,, GET OUT OF THE UNIT.....!!!! Then what is the worst thing that can happen??? they tear the unit apart and the cops come and tazer him/her. Self perservation is job #1. let the police handle the violent person. Most Police will not transport a violent "psych" patient or even a violent prisoner in a cruiser, the back of the EMS unit is a lot easierr to handle someone that breaks bad. !!!

[Just Plain Ruff]

and how bout those patient who get loose and jump out the back of the ambulance. Yee haw, those are the fun ones.

I used to call in to dispatch and say "We got a runner please send PD"