My career was nuts.


The patient is a twenty-two year old, intoxicated, emotional, possibly suicidal male. He’s six feet tall, weighs 250. He’s been drinking and fighting for two days. His clothes are torn, he smells like a cow and is soaked with sweat. His eyes are going in different directions. His mother states he is dangerous, she is afraid for her safety. Four or five police cruisers are on scene, the patient is slouched on some stairs, crying. Rescue 1 arrives on scene.

“You all set?” asks one of the cops as they prepare to leave.

All set? Just who is crazy here? Rather than transport a potential murderer to the emergency room for a psychological evaluation in  the back of a police car, with a cage between the driver and patient, locked and secure doors and hard to break glass and padded seats, let’s put him in a box with plenty of room to roam, glass and needles everywhere, sharp, hard things that could cause serious bodily injury if one were to be thrown or fall on if a wrestling match happens and a Rescue Lieutenant whose fighting years are long behind him, unarmed, untrained at restraining violent patients and hope he gets to the hospital.

All set? Are you crazy? The police tell me it’s their protocol to call EMS for transport of psych patients.

Well, it’s my protocol to tell you, no way. Usually. This time, for reasons I have no way of explaining, because I have no idea why I went along I put him in the truck. The hospital was only two minutes away.  I put him on the bench seat and fastened the seat belt. I should have known better. I should have put him on the stretcher, had a police officer come alonng and handcuff him to it. I didn’t.

Brian drove, checking the rear view mirror all the way. Half way there the monster  stopped crying and started mumbling unintelligibly. Then he figured out the seat belt was the only thing between him and me, his captor. He undid the buckle. Then he stood. Then, he fell. Right on top of me. I pushed him to the floor, he fought a little and started thrashing around at my feet. Then, he vomited, all over my shoes.

I should know better. Guess I’m the crazy one after all. Never again.

Yup, I’m all set.


  • Shane Lockard says:

    So this patient – he is a patient – has altered mental status (mumbling unintelligibly) and vomiting? This sounds like a medical patient to me. Did you even check a blood sugar?

    Yes, EMS needs to take protective measures with behavioral health patients – such as appropriate restraints and additional personnel (like a police officer). However, having a psychiatric or behavioral condition does not make it “not my problem” for EMS. Many patients with psychiatric conditions also have unmanaged medical conditions, drug additions, and alcohol abuse.

    You call this patient a “moster”. I think it is time for you to re-evaluate you reason for being in EMS.

    • Emily Gering says:

      ^^^ Seconding this. We all know it’s easy to fall into the trap of making assumptions about patients like this (“oh he’s probably drunk” is one I’ve been guilty of more than once) but it’s important to remember that these patients ARE people and deserve to be treated as respectfully as possible in a given situation. And we generally don’t know for a fact that that they’re not suffering from a medical condition that is presenting with AMS.

  • Troy says:

    Michael I second your thoughts as a 13+ year medic in a large metro population. All to often law enforcement has no forethought about the dangers we face. While I agree with the comments made regarding this patient as having true medical issues, what are we as prehospital providers going to in most cases? Good medical judgement includes thoughts on your safety as well. It’s time for a new protocol to follow officers while they transport perhaps when these patients present stable!.

Leave a Reply

Your email address will not be published. Required fields are marked *