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Dealing with Psychiatric Emergencies

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By John Morse

As first responders we often are in situations that involve people or patients with psychiatric issues.  Sometimes these people call us for help, sometimes others call on their behalf if they are needing help, and sometimes they are just a part of a situation. Statistically EMS providers deal with psychological disorders on 12% of all calls. No matter what the call, we need to always be prepared to deal with people that might need a little special care.

The most common psychological disorder is depression. There are enough statistics published on depression to write a book.  From teenagers to the elderly, we all are prone to depression at some time on our life.

I get tired of saying that the first priority on any call is our own personal safety.  I have heard that so many times in my career that it seems like it doesn’t need to be repeated at every training session.  As tired as I get of hearing and saying that, we all need those constant reminders of the importance of ensuring our own personal safety.

The most serious of these calls would be a psychiatric patient with a weapon.  There isn’t much we need to do with these calls, except stay away until the police handle that part of the emergency.  Once they have the person under control, we can approach the scene and take care of the patient.  It is easy to say “let’s just go in a see if we can handle it” but that is foolish.

There are also instances where we encounter violent patients without police.  I was involved in a call that was supposed to be routine, however it that turned pretty serious.  We were taking patient for a psychological evaluation.  When we entered the house, we found a young male dressed in a red jump suit, with belts of ammunition draped over his shoulders and around his waist.  When he saw us, he immediately retreated to a bedroom.

We called for police and were getting ready to wait outside for the police when he came out of the room and began throwing planters across the room and saying we were in for it because his friends were coming.  We talked with him for a while and he calmed down and was just about to sit on the stretcher when he became very violent.  While we were trying to restrain him to the stretcher we heard behind us the cocking sound of a shot gun.  This could have been pretty ugly, but it was a large group of police officers that had come into the house.  We turned the patient over to the police and got out of there rather fast.

First responders can be very effective dealing with these calls just by talking to the patients and calming the down.  A calm friendly voice is better than any medication, and it can completely change the tone of the call.  When you threaten someone who already feels threatened and scared, things just get worse.

If you are in harm’s way dealing with a psychological patient, get out of the way.  If you aren’t in danger, be calm and be a friend, things work out much better that way.

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