EMS Defensive Tactics

[MedicB12]

With the term Scene Safety, should Defensive Tactics be apart of EMS training? Either in basic or Ongoing CME's?

 

[ShockableAsystole]

With the term Scene Safety, should Defensive Tactics be apart of EMS training? Either in basic or Ongoing CME's?

I was various taught defensive tactics as part of my basic training. We had a police training agency come join us for a couple days to teach us how to defend ourselves, how to get out of situations, and how to avoid them altogether.

A lot of the things I learnt, I do use daily... where to position yourself when 'rousing' an unconscious/drunk, understanding your exit path, maintaining a distance that enables self defense etc, thankfully with the more combat side of things I haven't had to make use of! We have a little red emergency button on the top of our radios that in my experience has about 5 police cars with you within a few mins... Over a stab vest, training, or any weapon...I'll choose my little red button as invaluable!

 

[Chimpie]

With the term Scene Safety, should Defensive Tactics be apart of EMS training? Either in basic or Ongoing CME's?

Yep, and one of our members, who is also a Verified Vendor, teaches defense tactics for EMS professionals. (DT4EMS) He has his own section here too.

http://www.emtlife.com/forumdisplay.php?f=49

If you have any specific questions for him, that's the best section to post it in.

 

[Veneficus]

With the term Scene Safety, should Defensive Tactics be apart of EMS training? Either in basic or Ongoing CME's?

Yes to both.

Unfortunately it is not regularly taught at all.

Having started my career in the fire service, I can say the information on scene safety I got there far exceeds anything that the current EMS curriculums do.

I am also a supporter of DT4EMS.

I think the current "scene safe" idea is BS. It takes hours upon hours to barely touch upon scene hazards. Still more hours for hazards patients, bystanders, and would be patients present.

Like anything else, if you don't constantly use/review/train on it, the skills will be lost.

 

[DT4EMS]

Hey All,

Well........ to answer the OP......

The term/techniques Defensive Tactics as commonly known to Law Enforcement has nothing "defensive" in it.

When I started DT4EMS in 1996..... many people confused what I was teaching because I named it "Defensive Tactics for EMS".

Now that we have 71 people teaching my material across the country.... we are doing several things......

1) Proving that DT but I now call mine "Escaping Violent Encounters" for EMS/Fire is a required subject for EMS/Fire and ER staff.

2) Changing the "culture" of EMS via defining the difference between a "patient" and an "attacker/aggressor".

3) Removing the words "Combative Patient" from pre-hospital medicine lingo. Such a person does not exist.

4) Proving the EMS must train in a system designed for EMS (not a martial arts class or modified police style -pain compliance- techniques)

So the answer is........ my goal is to have my program, or something of similar standards a part of EMS curriculum AND ongoing CEU's. (Which I have already) But I want it to be STANDARD for all.

 

[ShockableAsystole]

3) Removing the words "Combative Patient" from pre-hospital medicine lingo. Such a person does not exist.

Do explain.

EMS brings a great variety of "patients". I think most all of us could indicate a patient who belongs in that category for a majority of reasons... There are the medical cases (intoxication, phsyc, metabolic disorders, trauma head inj etc) where it is understandable, then there are the plentiful other cases where we have combative patients with little cause... We are still left defending ourselves regardless of reason, the "cobative patient" exists... it isn't lingo, it's reality.

Even the 'drunk' 'hypo' or 'dementia patient' can quite reliably be defined as combative so I'm just curious what you mean? We often find reasons for patients combative state, it doesn't change our documentation of the 'combative patient' we just dealt with.

 

[DT4EMS]

Do explain.

EMS brings a great variety of "patients". I think most all of us could indicate a patient who belongs in that category for a majority of reasons... There are the medical cases (intoxication, phsyc, metabolic disorders, trauma head inj etc) where it is understandable, then there are the plentiful other cases where we have combative patients with little cause... We are still left defending ourselves regardless of reason, the "cobative patient" exists... it isn't lingo, it's reality.

Even the 'drunk' 'hypo' or 'dementia patient' can quite reliably be defined as combative so I'm just curious what you mean? We often find reasons for patients combative state, it doesn't change our documentation of the 'combative patient' we just dealt with.

See....... therein lies the problem.

Purely definition. The idea is to have EMSers grasp the true difference between an "uncooperative patient" and an attacker. My research shows there is a reluctance to defend/escape when they keep thinking a person is a "patient".

for instance-- A cop turns over a drunk.....who has a scratch on his knee..... no real medical complaint except the guy wanted to get away from the cops....so he wants to be evaluated. Going down the road he decides to assault staff...... is this guy a patient? or is he an attacker?

Too many times it is documented as a "combative patient". The verbiage paints a picture of the guy not really trying to hurt staff. When in all actuality...the drunk piece of *** is attacking and should be defended against, escaped from and prosecuted.

It IS lingo. Period. If the person has a true medical condition they should be called "uncooperative patient".

The word "combative" is defined as "ready or inclined to fight". Although difficult to prove in court "INTENT" is what we are discussing. This is why it has taken me over 16 years of teaching this program to finally be getting national and international attention.

It is about changing the "culture" of EMS.

 

[DT4EMS]

And.......

there is a distinct difference between a drunk/drugged person and an hypoglycemic or TBI patient.

Just because a person is "high" or "drunk" does not automatically make them a patient. Nor does it negate any criminal activity (assault) they commit.

 

[ShockableAsystole]

See....... therein lies the problem.

Purely definition. The idea is to have EMSers grasp the true difference between an "uncooperative patient" and an attacker. My research shows there is a reluctance to defend/escape when they keep thinking a person is a "patient".

for instance-- A cop turns over a drunk.....who has a scratch on his knee..... no real medical complaint except the guy wanted to get away from the cops....so he wants to be evaluated. Going down the road he decides to assault staff...... is this guy a patient? or is he an attacker?

Too many times it is documented as a "combative patient". The verbiage paints a picture of the guy not really trying to hurt staff. When in all actuality...the drunk piece of *** is attacking and should be defended against, escaped from and prosecuted.

It IS lingo. Period. If the person has a true medical condition they should be called "uncooperative patient".

The word "combative" is defined as "ready or inclined to fight". Although difficult to prove in court "INTENT" is what we are discussing. This is why it has taken me over 16 years of teaching this program to finally be getting national and international attention.

It is about changing the "culture" of EMS.

When I said "Do explain." I thought i would unintentionally provoke something unintended, Instead, I agree with everything you just said. That said, most of us understand the difference between our "patients" and an attacker, the difference comes in how we are trained to deal with said person. In the UK we are trained with what we are likely to face (ie.. knives...not guns) so I am sure it is different to the way tactics are taught in the US of which I cant comment.

It's symatics to define a 'combatitive dementia patient' as uncooperative vs your drunk fobbed off from police. Both are combative, both have different reasons for being so, and both require skills in managing. "Combative patient" isn't lingo when it comes to my paperwork. If you want to call them an uncooperative patient then fine, I will call the abusive dementia patient as combative despite their "true medical condition". It's not a reflection on the patient, it's presenting things as they are.

 

[DT4EMS]

When I said "Do explain." I thought i would unintentionally provoke something unintended, Instead, I agree with everything you just said. That said, most of us understand the difference between our "patients" and an attacker, the difference comes in how we are trained to deal with said person. In the UK we are trained with what we are likely to face (ie.. knives...not guns) so I am sure it is different to the way tactics are taught in the US of which I cant comment.

It's symatics to define a 'combatitive dementia patient' as uncooperative vs your drunk fobbed off from police. Both are combative, both have different reasons for being so, and both require skills in managing. "Combative patient" isn't lingo when it comes to my paperwork. If you want to call them an uncooperative patient then fine, I will call the abusive dementia patient as combative despite their "true medical condition". It's not a reflection on the patient, it's presenting things as they are.

That is where I am trying to make one of the changes...... DOCUMENTATION. I have interviewed good EMSers who have lost their job due to documenting how they legally defended themselves.

A "patient" will rarely if ever be prosecuted. An Attacker on the other hand is prosecuted.

A simple change in verbiage to "uncooperative patient" more accurately describes what a patient is. Example: You have a hypo/TBI..... they push you away or pull away non-purposefully trying to keep you at bay.

A drunk or drugged person who tells you they are "gonna kick your ###" and moves forward to do so is NO PATIENT.

Unlike you in the UK which has a national attempt to bring recognition to the problems of assaults on EMS, here in the US it goes way under-reported and under-addressed.

I am familiar with what you are taught in the UK. Overall it is a sound program.

 

[DeepFreeze]

I really enjoy the concept that you have for dt4ems/fire. Are there any those type of courses, similar to yours, that you could recommend in the Boston/New England area?

 

[DT4EMS]

I really enjoy the concept that you have for dt4ems/fire. Are there any those type of courses, similar to yours, that you could recommend in the Boston/New England area?

Yup. I have a guy there now. He is in Worcester. He just finished teaching his first class and the course evals where fantastic. I will PM you his contact info. I believe he has a couple more classes scheduled already.

 

[DarkStarr]

Good thread. I recently took an EMS Street Survival Seminar through EMS1/Calibre Press with a coworker in Atlantic City, NJ. Great class, learned a lot. We have been sharing what we learned with our other coworkers as well.

 

[newenglandeve]

Good thread. I recently took an EMS Street Survival Seminar through EMS1/Calibre Press with a coworker in Atlantic City, NJ. Great class, learned a lot. We have been sharing what we learned with our other coworkers as well.

Did you attend the December program? I was there as well. That program provided a good overview of how to stay safe, but if you really want a good defensive tactics program, check out Kip Teitsort with DT4EMS. The program has been developed over the last 16 years and is fantastic! You can find this program on the Forums here or visit his website at dt4ems.com