The Handover: Crisis Patients

For the month of July, I was selected to host The Handover, an EMS Blog Carnival. The topic I chose to tackle? The Crisis Patient. Not a day goes by where I don’t have to deal with a psych crisis patient. They’re out there, we all run into them, and the training that we get to be able to deal with them is minimal. Focus moves towards ACS patients, strokes, respiratory patients, or trauma scenarios. While treatment of these patients is usually rather involved, it takes the focus away from our less acute crisis patients, which are viewed as more routine, and easy to care for. They are, however, far from either of those descriptions. Take a read through the blogs below. Chances are you’ll see a situation that you’ve been through in the past. The Insomniac Medic shares the story about an encounter with a patient where a special bond was created, and because of it he was able to get his crisis patient the help that he very much needed. The Happy Medic dug into the archives for his contribution to this month’s Handover. He’s asked by the Police Department to help remove someone that many of us have encountered: a horder. Physically, she’s fine. Mentally, she’s competent, but sometimes we are forced to make decisions in the best interest of our patients. Our friend over at Paramedic Pulp Fiction takes the time to talk to his already restrained crisis patient, and takes the easier, less forceful way out. Taking this approach not only made his job easier, but could potentially make things easier on the next crew that encounters this guy. Often times, its important that the provider takes control when dealing with a crisis patient. Over at Street Watch, we get to hear a story from 2006 about a rather large crisis patient with the potential to escalate a situation to a physical level. He remains in complete control of his scene and his patient, but he gives her the chance to feel like she’s in control with a few simple actions: letting her have a cigarette and giving her simple choices about how care is provided to her. Our...

On The Throne

With all of the writing I’ve done today, this week should be a pretty busy week atEMSin the New Decade.I’m waiting on submissions for my topic for The Handover, the topic of which can be read here.Also, I’ve got a two part post almost completed about the Massachusetts EMT Recertification scandal that is currently taking place.I thought though, on this Sunday, which is supposed to be a day of rest, that I would start things off on a lighter note. Jeramedic called me out in one of his blog posts.The question was, “What reading material do you keep next to the toilet?”I don’t know exactly how this thread started, but from what I’ve researched, it seems that all of it goes back to TheHappyMedic.Thanks, Justin! So when I “sat down” before, I took inventory of my library that would most certainly be flagged in an episode of Seinfeld.Here’s what I found JEMS — If you work in this field, chances are you have at least one copy lying around the bathroom somewhere.My current selection is the 2010 200 City Survey edition.There are some great articles in that one.I highly recommend it. PC Gamer — There are a few month’s worth of this magazine hanging out in the rack.Its my guilty pleasure, and my hobby when I don’t really feel like heading out to face the world.That’s right, folks.MedicSBK is a gamer! Cowboy in the City — This is a book aboutEMSin the area where I practice.The writing style is. . . unique to say the least.I’m not sure about the overall message of it, but I’ll usually read a page or two here and there. The trusty iPhone! — When all else fails, chances are my iPhone is nearby.Not only does this give me plenty of websites to tackle, but I will admit there has been the occasional Tweet (or as I believe its called Shweet) that goes out, but you’ll never know which ones those are! Muahahahahahaha! So there you have it!Plenty of reading material to keep me occupied.Seeing as how everyone who I would call out on this one has already written some great articles about this same topic, I guess I...

The Handover: Crisis Patients

Well, its July, and its my turn to host The Handover.I’ve done a lot of thinking over the last couple of weeks after I was given this task, and I feel like I’ve come up with a good topic. Throughout my schooling to become an EMT and a Paramedic, I received a lot of education and information about treating strokes, and traumas, and MI’s.I’ve learned how to read 12 leads, and I’ve tubed and cannulated my fair share of patients.There have been times though in my career where I might go a rotation without dealing with a critical patient.There is one patient that always has seemed to be present in my EMS Career as a Paramedic, and coincidentally, it’s a class of patient that was not touched upon as much by my Paramedic and EMT instructors: The Crisis Patient. These patients come in all shapes and sizes.Some are as young as 5 or 6, and some as old as 70 or 80.They all present differently.Some are suicidal, some homicidal, and some depressed.Some of them are very cooperative, many show passive resistance, and others, unfortunately, insist on being difficult. Recently in my system, because of a few incidents, techniques for dealing with these patients has been a hot button topic.Some crews are reluctant to go into scenes without the Police Department or a Supervisor present.Instead of blindly pushing people through the door of a residence, I’d like a chance to take from you, my esteemed, intelligent colleagues, some of the techniques that you use to deal with these crisis patients.So I was wondering: – How do you approach these patients?How conscious are you of your body language around these people – When a patient is resistant or reluctant to receive treatment and transport, how do you like to handle that? – In your time with these patients, how much do you dig into their history, and reasons for feeling depressed, suicidal or just “not right?” – Finally, when it comes down to it, what techniques do you use for subduing and restraining a patient? So how do you contribute? Just post a link to your blog as a comment to this post, and I will...

See You Soon, Mark

I’ve had a lot of blog ideas for this week’s edition of EMS in the New Decade kicking around my head: Health Care and EMS, the ongoing Massachusetts EMT scandal, and a few others, but I feel it more appropriate for right now to put those on the backburner and say goodbye to a colleague, and a pioneer who has played a huge part in the movement to make my job better: As many of you know, Mark Glencorse has decided to close down his 999 Medic blog.I understand and sympathize with him for his main reason for doing this: family comes first, but that doesn’t mean I’m not going to miss his posts. When it comes to Blogging Age, I’m still a young’n.My blogging career didn’t get started until March, which is nothing compared to Mark’s 18 months and more than 450 posts.Heck, I remember my first night on Twitter when I got to join Justin and Ted on their limo ride intoBaltimorevia UStream, and later reading about Mark’s experiences at EMS Today. That gradually evolved to where I had my plane tickets on standby to fly toDenverjust to spend the evening with the poor guy and share a beer or two because of some silly volcano that had stranded him state-side. This is my chance to say thank you, Mark.Thank you for everything that you have done.Thank you for being a leader in the Chronicles of EMS movement.Thanks for pointing us in a positive direction to help fix our struggling nationalEMSsystem.Thanks for your fun comments on all of our blogs, and thanks for all of your posts over the last 18 months.Most of all, Thanks for being willing to take time away from your family to come and share your knowledge with us.I can only imagine what a huge sacrifice it must have been for you and it means more to many of us than you could imagine. Now it is time for the rest of us to carry the torch, and pick up where Mark is leaving off.I’m sure there will be many occasions when we will all say “remember what Mark said?”And share all of those words of wisdom.The wisdom...