PD on scene goading your patient. What to do?

adamjh3

Forum Culinary Powerhouse
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I had an IFT call a couple nights ago that raised some questions for me.

We were dispatched to ESU - Emergency Screening Unit

The Emergency Screening Unit provides emergency psychiatric evaluation, crisis stabilization, and brief outpatient counseling to children, adolescents (age 17 and under) and their families in crisis.

Encountered a 17yo M. in handcuffs flanked by two LEOs. Pt. was aggravated, verbally aggressive towards the officers, myself and my partner.

C/C of disturbance in behavior secondary to ETOH consupmtion. Pt. encountered by PD at home after mother called feeling she was in danger. En route to ESU Pt. stated he was suicidal/homicidal.

Normally adolescents brought in to ESU by LE are left in the care of the facility and PD goes on their merry way. The Nurse at the facility stated as soon as PD released the handcuffs from the pt. he became violent and assaulted the two officers, thus the police placed the cuffs back on and stayed there with him until we showed up.

Pt. was going to the ER to be evaluated and treated for the ETOH consumption.

With PD assistance we got him on our gurney and in 4pt velcro restraints without too much difficulty. At this point the patient seemd to have calmed down a bit when I talked to him, asked him what was going on, etc. After we got him in the ambulance the Pt. looked me in the eye and said he was going to get out of the restraints, one officer said "Go for it, if you're lucky you'll rub your wrists raw." At that point the patient became more agitated/aggressive, began fighting the restraints, spitting, and yelling the he'd "get out and kill all of us."

The officer continued to taunt the patient up to and including physically pushing him back down on to the gurney. I'll admit that the officer was pretty witty, and if I was watching this on an episode of "Cops" I might have gotten a couple chuckles, but I felt this was wholly inappropriate and my partner and I could have kept him calm or at least compliant.

I took the officer aside and informed him that my pt. was likely becoming more aggresive because of how he was being talked to. I informed him that we could probably calm him down for the tx, but asked him to follow us over to the ER just in case. After much internal debate, the officer agreed to send the other officer on scene to tail us in his car.

During Tx the pt. was pretty calm, we talked about the playoffs and football, and he was completely fine.

With that out of the way, how would you have handled this situation?
 

lampnyter

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I would of told the cop down right to stop. If the cop is interferring with you getting history from the patient then he needs to stop talking.
 

LonghornMedic

Forum Lieutenant
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Sounds like it went as well as it could of. The cops may have been a little aggressive, but i think all of us get a little like that when getting spit on and physically assaulted.
 

JPINFV

Gadfly
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Get a new cop or have that one follow you behind the ambulance.
Write incident report.
Sleep well at night.

Sounds like it went as well as it could of. The cops may have been a little aggressive, but i think all of us get a little like that when getting spit on and physically assaulted.

Sorry, there's no reason to sit there and provoke a patient in restraints, regardless of what happened prior. [severe hyperbole] It's like justifying Abu Grhaib because it's the enemy, and who cares what happens to the enemy once they become prisoners. Oh, that goes for anything that happens to our POWs as well. You can't complain about mistreatment, than partake in it yourself[/hyperbole]

If that was your family member, you wouldn't be so happy that the police officer is harassing your family member.
 

LonghornMedic

Forum Lieutenant
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Get a new cop or have that one follow you behind the ambulance.
Write incident report.
Sleep well at night.



Sorry, there's no reason to sit there and provoke a patient in restraints, regardless of what happened prior. [severe hyperbole] It's like justifying Abu Grhaib because it's the enemy, and who cares what happens to the enemy once they become prisoners. Oh, that goes for anything that happens to our POWs as well. You can't complain about mistreatment, than partake in it yourself[/hyperbole]

If that was your family member, you wouldn't be so happy that the police officer is harassing your family member.

Well, we were not there. It doesn't sound like anything major happened. Not like the guy was beat down while in restraints. Never did I say it was okay. But we are all a little guilty of overreacting at one time or another. I'm about as level headed as they come. But the one thing that pisses me off is getting spit on. I'm not going to beat you up, but I am sure as hell not going to be nice and polite. I won't call you names or make fun of you. But my compassion went out the door as soon as you spit or assault me. At that point my demeanor changes and I say little other than to ask what is required of the patient. I just don't think this incident, as described, is worthy of getting bent out of shape over.
 

JPINFV

Gadfly
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But the one thing that pisses me off is getting spit on. I'm not going to beat you up, but I am sure as hell not going to be nice and polite. I won't call you names or make fun of you. But my compassion went out the door as soon as you spit or assault me. At that point my demeanor changes and I say little other than to ask what is required of the patient. I just don't think this incident, as described, is worthy of getting bent out of shape over.

I'm not saying that someone who was spat upon needs to be all nice and cuddly and all instead of cold while being professional. However, there's a difference between doing the minimal for the patient in terms of communication and being a douche. Based on the description, it looks like the officer crossed that line.
 

SanDiegoEmt7

Forum Captain
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I had an IFT call a couple nights ago that raised some questions for me.

We were dispatched to ESU - Emergency Screening Unit



Encountered a 17yo M. in handcuffs flanked by two LEOs. Pt. was aggravated, verbally aggressive towards the officers, myself and my partner.

C/C of disturbance in behavior secondary to ETOH consupmtion. Pt. encountered by PD at home after mother called feeling she was in danger. En route to ESU Pt. stated he was suicidal/homicidal.

Normally adolescents brought in to ESU by LE are left in the care of the facility and PD goes on their merry way. The Nurse at the facility stated as soon as PD released the handcuffs from the pt. he became violent and assaulted the two officers, thus the police placed the cuffs back on and stayed there with him until we showed up.

Pt. was going to the ER to be evaluated and treated for the ETOH consumption.

With PD assistance we got him on our gurney and in 4pt velcro restraints without too much difficulty. At this point the patient seemd to have calmed down a bit when I talked to him, asked him what was going on, etc. After we got him in the ambulance the Pt. looked me in the eye and said he was going to get out of the restraints, one officer said "Go for it, if you're lucky you'll rub your wrists raw." At that point the patient became more agitated/aggressive, began fighting the restraints, spitting, and yelling the he'd "get out and kill all of us."

The officer continued to taunt the patient up to and including physically pushing him back down on to the gurney. I'll admit that the officer was pretty witty, and if I was watching this on an episode of "Cops" I might have gotten a couple chuckles, but I felt this was wholly inappropriate and my partner and I could have kept him calm or at least compliant.

I took the officer aside and informed him that my pt. was likely becoming more aggresive because of how he was being talked to. I informed him that we could probably calm him down for the tx, but asked him to follow us over to the ER just in case. After much internal debate, the officer agreed to send the other officer on scene to tail us in his car.

During Tx the pt. was pretty calm, we talked about the playoffs and football, and he was completely fine.

With that out of the way, how would you have handled this situation?

Sounds like this was out of County Mental Health? Sounds like you did everything correctly.
 

Bullets

Forum Knucklehead
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sounds like your a nicer guy then me. if he spit on me i would have broke his nose. I also would have told the cop to get a case number for assault cause im pressing charges once i transfer care.
 

C.T.E.M.R.

Forum Lieutenant
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Heck if i had a patient like that i would make sure hes calmed down before he goes in the rig. And by the way most cops hate having to follow the ambulances, And yes some can be jerks, they don't care if the situation gets better. Working i the EMS field you will encounter people like that and they do need to be told what they're doing wrong and that it doesn't make your job easier.
 

LucidResq

Forum Deputy Chief
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sounds like your a nicer guy then me. if he spit on me i would have broke his nose. I also would have told the cop to get a case number for assault cause im pressing charges once i transfer care.

You're either a troll or freaking insane/dumb if you think that the patient would be the one facing assault charges in such a situation. YOU would, you would almost certainly also lose your job and certification and probably never be able to get a job in healthcare again.
 

CAOX3

Forum Deputy Chief
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sounds like your a nicer guy then me. if he spit on me i would have broke his nose. I also would have told the cop to get a case number for assault cause im pressing charges once i transfer care.

Do you always resort to violence?

Do you have any other problem solving skills beside your fist?

Do you need to beat everyone who poses a threat to you? It is a little more fulfilling to diffuse a situation using diplomacy. Maybe give it a shot.
 

46Young

Level 25 EMS Wizard
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sounds like your a nicer guy then me. if he spit on me i would have broke his nose. I also would have told the cop to get a case number for assault cause im pressing charges once i transfer care.

It takes a real tough guy to crack a perp in the face when the cops are onscene and got your back, ESPECIALLY when said perp is restrained. If I was the perp, I'd press charges against you for striking me while I was unable to defend myself. The court is not gonna buy it when you try and argue that spitting equals a closed fist to the nose.

Striking a defenseless perp while restrained by police tells me a lot about your character. Those who step up to the plate and fight the fair one without hesitation don't beat up on those that can't hit back.

I worked in the city too. I've dealt with many a violent EDP. What I didn't do is take cheap shots on them when they spit, try to bite me, curse my mother, etc.
 

firetender

Community Leader Emeritus
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"Officer, I agree, the guy deserves a (whatever, spice to taste), but I'm here to get him out of your life. Please don't agitate him anymore because the hemorrhoid you're dishing out lands on my ***."
 

Indy

Forum Crew Member
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I have nothing but respect for police officers. If a Pt. is aggressive, officers will use necessary force to control the situation. EMTs/Medics aren't cops, EMS personell are not trained in law enforcement tactics and vice versa (in most cases anyways). EMS does their job as they were trained to do so, and LEOs do their job as they were trained.
 

fortsmithman

Forum Deputy Chief
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sounds like your a nicer guy then me. if he spit on me i would have broke his nose. I also would have told the cop to get a case number for assault cause im pressing charges once i transfer care.

Personally I would not hit the pt, but I would have filed criminal charges against him.
 
OP
OP
adamjh3

adamjh3

Forum Culinary Powerhouse
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I have nothing but respect for police officers. If a Pt. is aggressive, officers will use necessary force to control the situation. EMTs/Medics aren't cops, EMS personell are not trained in law enforcement tactics and vice versa (in most cases anyways). EMS does their job as they were trained to do so, and LEOs do their job as they were trained.

I know I'm not a cop, but I am a human being, and being taunted and tested while I'm inebriated, restrained, and in a weird place would definitely agitate me. Getting in a shouting match with a patient who was previously calm is not necessary force.

Bullets, I don't think a cheap shot to a restrained patient (who is a minor nonetheless) would hold up very well in court as self-defense. Even if you pull the "but he had HIV, I was afraid for my life."

SDEMT, it was out of ESU down in Chula. Like CMH for kids. Thanks for the kind words. I thought I handled it pretty well. We don't deal with PD much doing IFTs, so this was a first for me.
 

Seaglass

Lesser Ambulance Ape
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Common enough scenario. How I would've handled it depends on the particular cop. Assuming it was someone I didn't know, I would've handled it the same way as the OP.

Personally I would not hit the pt, but I would have filed criminal charges against him.

For spitting?

Personally, I'd need to be hurt before I file anything. If he's positive for any serious cooties, my system is supposed to tell me and handle it appropriately.
 

Linuss

Forum Chief
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The officer continued to taunt the patient up to and including physically pushing him back down on to the gurney.

Now, define 'taunt'. Saying "go ahead" is no big deal. Calling someone a cootie-face? Different story.

As for pushing back down on the gurney, again, so what? You really don't give enough info to make it seem unjustified. If I have a restrained patient actively trying to fight the restraints and get up, they ARE getting put back down. That's not taunting a patient, that's not abuse, that is keeping everyone safe. Granted I have plenty of drugs that I can give to knock said patient out so that they stop fighting, but still.


I'd be lying if I said I was never in the situation where a restrained patient threatened me and my comeback was "Ha, you can try" or something to that nature. Who cares? That's taunting? Wow this country is too PC.


For spitting?

Personally, I'd need to be hurt before I file anything. If he's positive for any serious cooties, my system is supposed to tell me and handle it appropriately.

Hell yes for spitting. A person who spat in a Dallas Police Officers face a couple of years ago was found positive for HIV. He was charged with assault with a deadly weapon against a police officer.


In the state of Texas, attacking a Paramedic doing their job is a felony. You attack me, whether or not it hurts is irrelevant, you'll get in trouble--- as 2 already have this year.
 
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Veneficus

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Could I just offer some perspective?

sounds like your a nicer guy then me. if he spit on me i would have broke his nose. I also would have told the cop to get a case number for assault cause im pressing charges once i transfer care.

I would recommend staying away from the street justice.

First off, if you strike this patient out of anger, you are going to carry more fault than him.

Even if you think the cops got your back, if they have to choose between themselves and you, it won't take much to figure out who is going to come up short.

When you get to the ED, the patient is going to be interviewed and examined by a host of people. When it comes out you broke his nose when he was reststrained, you are going to be in a world of hurt.

Your medical director cold decide you are unfit to practice, and let's face it, if you are beating down patients with an ALOC out of premeditated anger, you are not fit to practice. He can then refer you to the state for discipline and I doubt you will find any sympathy or mercy there.

Never go to court without clean hands. Pressing assault charges after striking the patient makes you guilty of a crime. (probably a few) I doubt very much any DA would persue the charges against a rowdy psych anyway. It is a losing case and lawyers generally don't like to waste time on obvious losses.

If you are called to testify are you planning to take the 5th or purjer yourself?

How much is in your personal budget to cover the cost of a defense lawyer or are you plannig to go with a public defender?

Even if it never makes it to court, how do you think your employer will respond?

Before you decide to let your anger get the better of you, or that you are somehow morally superior, consider that in the role of a medical provider, you must demonstrate the proper way to react. Your respect and position is given to you for your ability to rise above the common person and demonstrate care without judgement.

If you don't plan to be spit on, called names, punched, kicked, and all manner of potential or actual injury, you might want to start looking for another job now. Right or not, it is a regular part of the job.

I urge you to carefully reconsider your position.
 
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