Management of Violent Patients                                                                      Page 64-1

MANAGEMENT OF VIOLENT PATIENTS

INTRODUCTION

Never transport these patients without police presence. When transporting these patients without police presence use of the following protocol is permitted. Patients often present with bizarre and unpredictable signs and symptoms. These patients must be handled with extreme care. One moment calm and serene, suddenly violent and out of control, or worse, sorrowful and weeping. Occasionally these patients change form from human to extraterrestrial. Note that these patients may be at risk of mutating, shape shifting or morphing into creatures of the night.

RECOGNITION

Patients whose color changes rapidly, grow fangs or claws or simply disappear fit into this category. Do not rule out drooling, leaking or other bodily emissions as potential weapons. Occasionally, these patients rip seat belts from stretcher and flop on floor of rescue vehicle. Some levitate. Some attack.

TREATMENT

1.          Perform a primary survey. Handle patients gently, sudden movement may provoke them.

1.1       Tie combative patients to stretcher using whatever means available, preferably face down. If one of these patients breaks loose,         use of a sheet as a safety net is permitted. Throw sheet over escaping patient, temporarily confusing them. Beat them with a loaded clipboard if necessary. Gently resecure patient to gurney.

1.2      Use of retrievable portable radio may be used to stun escaping patient. Hold microphone section of radio and use body as a projectile. Aim for the back if running away, between the eyes if approaching. Repeat as necessary.

1.3      Teamwork is recommended when volatile patient attempts to elope from rescue. Driver must monitor progress as is prudent. If patient manages to escape from restraints, quick starts and stops should incapacitate patient. Team member in rear of truck may utilize safety net (see 1.1) Planting foot behind subdued patients neck and firmly pressing to floor should alleviate the situation.

1.4       Consider abandoning vehicle.

2.        Obtain Vital Signs

2.1      From safe distance see if patient is breathing. If so, no further treatment is necessary. Transport immediately to appropriate medical facility

2.2      If Patient is not breathing follow all appropriate protocols

2.3      If patient remains conscious, repeat above until desired effect is attained

3.      Document all incident information, except for all of the above, by completing the RI EMS Ambulance Run Report