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Old 07-29-2013, 05:13   #1
4Rules
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Self-Defence for Paramedics by W. Robin Young

This book is aimed primarily at Emergency Medical Service (EMS) paramedics but will also be valuable to other on-scene emergency responders such as fire fighters and crisis workers. Nurses, doctors, orderlies and security personnel in a hospital or clinic setting can also use this information. While this book can not cover every aspect of personal self-defence, the goal is to give you skills to add to your toolbox of training and work experience. The overall message of the book is simply to stay safe.
http://www.paramedicselfdefense.com/paramedic-self-defense-book.htm
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Old 07-29-2013, 06:09   #2
lethal tupperwa
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using a folded triangular bandage for restraint

fold in half run around arm pull end through loop

and tie end to cot.

with enough bandages for arms and legs

2 on each arm

3 on each leg

violent people can be safely

restrained if you don't

have any better restraints
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Last edited by lethal tupperwa; 07-29-2013 at 06:10..
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Old 07-30-2013, 07:04   #3
sasage
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I prefer the cravat method over the restraints that we are supplied.
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Old 07-30-2013, 11:52   #4
Halligan
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Situational awareness goes a long way as a medic. How you talk to your pt's is also a major factor. Time and experience is what gets you these.

I have only had one "bad" situation. My partner and I were attacked with a dagger (6in long) by a mental subject. He had mental history and was known by the dept. My partner and I knew he had issues so we were lucky and were heightened.

The Pt lunged at him with the dagger. He stopped the hand, I responded by restraining the other arm and we with force overpowered him. F.y.i it is difficult to get to your radio and call for help when you are fighting someone. Eventually we subdued him and PD was called.

Pd did not get to us for a bit and ultimately they did nothing. All you have is your partner and yourself.

Know your limitations, know your partner, get good at what you do, and go home safely.


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Old 08-10-2013, 13:38   #5
fyrediver
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I prefer to secure a combative patient to a backboard rather than my gurney. That way I can separate them at the ER without having to unsecure them and risk everyone's safety. Also, if they vomit I can roll over the board and clear their airway, again, without having to unsecure them. If they go into excited delirium they're already on a rigid board for CPR.

I use the one arm overhead wrist secured above the opposite shoulder and the other arm at their side. Tied at both the wrist and elbow. Seems to help eliminate their leverage even when they're hopped up. Also, above and below the knees. Then regular backboard straps.

Situational awareness is key to our safety. I'm not overly quick about bringing in PD or other FD units, but will if I think the situation warrants it.
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Old 08-10-2013, 13:44   #6
ranger1968
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Where are the cops when you guys are having to deal with all of this?

We get dispatched to every medical call, if for no other reason than scene safety; If we have a violence-related call that requires EMS to respond, they will stage a couple of blocks away until we specifically advise comms that the scene is safe for them; If the person is uncooperative, a unit will follow the ambulance to the hospital; if the person is actually combative, someone will ride in the back of the ambulance with the attending medic.....

Your LE is making you guys do your own scene security !?
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Old 08-10-2013, 17:16   #7
D25
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After the initial dogpile....

succinylcholine!

Stay safe.
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Old 08-10-2013, 17:34   #8
fyrediver
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"Your LE is making you guys do your own scene security !?"

Our PD is VERY supportive and provides GREAT security. However, sometimes the call doesn't come in appropriately and they're not included or the call degrades. Then we need to request them and try to stay safe until they arrive.

In fact we've got lots of young cops who are excited about helping out at any turn. One stopped by a call the other day and asked if he could help. I told him, "Sure, we've got a 78 year old male with a rectal bleed." Sort of dampened his enthusiasm. Not sure why . . .
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Old 08-20-2013, 07:53   #9
Joe BOLO
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Our system and procedures here are heavily weighted to over-triage (ie. use a high index of suspicion) on any potentially dangerous call during the call-take process. We are nearly always instructed to stage for the police on these calls. It can be very frustrating some times on calls you know involve critical patients and the police take a long time to arrive but we know they are doing their best. They are VERY good at watching out for us out there. My early experiences in another state were the opposite. We were sent to what ever came in and someone might notify the police later on. We wound up in more dicey situations there than here.

I totally agree with an earlier post that stresses that situational awareness is key. In fact, that statement dovetails nicely with another post I read in a different thread on this forum about mindset and awareness. I don't remember where it was but the point made was that a tortise, properly aware and forwarned of a dangerous situation can seem to act faster than a slow-witted and situationally unaware hare.

Most new field providers do not have good street smarts and instincts early in their careers but they learn over time if they pay attention and get good training. My "spidey senses" and the old "EMS gut instinct" are valuable attributes and they have served me well over the years but I did not have them when I first hit the streets 27 years ago.

It has been years since I had a partner because I am a supervisor and work a one man truck but I remember some of the conversations I had with rookie partners where I tried to pass along some of my street knowledge. It is hard to do at times because you just internalize the process and it becomes instinctual. Instinct and reflex are hard to recognize and explain. Anyway I remember the blank look when I said to not worry about taking the equipment along if we have to bug out from a scene. In fact, I told him to leave them in the way so whoever is threatening us has to go over or trip on them. Some calls are just going to go poorly and are, by nature going to be dangerous and physically taxing. Then there are those calls that we somehow manage to do the wrong thing and escalate a bad situation.

I think the simple approach is best here. Pay attention to what you are going in to. Be nice and be professional. Attempt to figure out what their expectations and needs are and exceed them. Show respect and concern for them and for their family/posessions. Always know how to get out of Dodge and don't get boxed in if you can avoid it. Be alert and have plan B, C, and D ready to implement. The list is endless......

Just yesterday morning I backed up a crew who called for backup on an unconscious person. I arrived at the residence to find no FD or PD on scene with the crew. I walked up the front sidewalk to the steps and noted that the front porch looked like a frat party went on there all night and ended only moments before...but there was NO ONE around. I stopped at the front door and announced myself loudly but there was no answer. The home was barely furnished and it was o-dark thirty in the morning just before dawn. I eventually got an answer and a man directed me through the house and up to the second floor. Then he walked off, apparently unconcerned. Now I noticed the smell of marijuana faintly. All is quiet as I go up the stairs so I does not look like I have to jump on anyone right away but I am on alert and a little edgy. Turns out, the situation was well under control by the crew and they had me coming as plan B. My eyes roamed the room as I took in each weapon or potential weapon, each empty bottle, and the paraphernalia in the room. Everyone was calm and it appeared that we were still viewed as friendly helpers but the potential for problems was there and there were limited ways to get out of Dodge (see earlier).

Calls like this are routine and nine times out of ten go off without a hitch but you still play the mental "what if" game each time just so you are prepared and ahead of the curve should things go bad. I knew who I was going to go for if I had to, I knew what I had to be concerned about (as much as I could anyway) and I had the confidence that the other providers on the scene were like-minded and would react in a similar manner. Those things go a long way to reduce the stress of routinely running calls in situations like this.

I am fortunate to work in an area that does not have a high incidence of violence against providers but we still exercise caution on each call. I know the list of priorities and actions will be very different for some of my brother and sister providers throughout the country. Situations vary widely too; Urban vs. rural. Ghetto vs. palatial mansions. Crowd vs. one-on-one.
Just my 2 cents....ok maybe this was a little verbose so it is my 75 cents.

-Joe
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