Patience with Patients

Fair Maiden is dispatched by the university's Public Safety department. Given this, you can understand that we don't always get the best or most reliable dispatches in the business. No times of transmissions, no detailed information, and no chance for updated reports., though PS is usually pretty good about sending an officer (read: security guard) to meet us at the job. We got toned out for a 'possible intoxication' at a student's dorm room around 3AM towards the tail end of the Friday night shift. Of course, this was the one time PS doesn't send an officer when we might actually need one.

We step off the elevator and walk into the suite... "EMS!" Note that PS wasn't able to obtain a specific room number, and so there we were: standing in the suite, everything quiet as a dormouse on Christmas Day. I was about to start knocking on random doors, when out pops a tall, slender, rather flamboyant looking kid, ~20 y/o...

"Oh hey guys! Heh heh, sorry about that. False alarm..." Note: this kid wasn't even close to needing an ambulance, so course that makes him only the supporting character, i.e., the friend trying to cover up for his pal who's currently in the room either puking or high. This is going to be pleasant, thought I...

"Well, can you tell me what's going on?"

"Oh, my friend had a little too much to drink, but she's alright, she's sleeping now. I just got off the phone with her mom, and she said to just let her be."

"Do you mind if I have a look?"

"Ummm, well, gee..." You could almost see the wheels turning in his head -- trying to figure out a way to prevent me from entering the room. Finally, "Alright, but she's sleeping."

I walk into the room to see exactly what he said, a female (wearing all her clothes), laying in bed, apparently sleeping. 'Great!' thinks I -- quick, easy RMA. Back to the friend, "What's her name?"

"Oh, Monique," says he. (Names changed, of course, to protect the guilty, and cover me from big bad HIPAA.)

Shaking the poor soul, "Hey Monique, how are you feeling? Monique... Monique..." Nothing. I can see she's breathing, and she feels warm and dry, and I'd be a monkey's uncle if she was actually asleep, but I'm not too concerned... "Monique, honey, what's wrong?" Suddenly...

"Will you just leave me alone! And stop calling me Monique! My name's Sandra!" Hmmm. The plot thickens. She's too drunk to realize her friend was trying to cover for her. Being drunk in a dry dorm won't get you in a lot of trouble, but it will earn you a call to your mother in the morning. I look back at the friend, giving him my best, "Monique...?" look.

"Oh, it's just a nickname...." Yeah, suuuurrrre.

As my partner tries to talk to the friend to get some real info and start the PCR, I try to talk to our patient, and ask her about the night's events.


Things quickly get out of hand.


I hear the friend shout, "I don't see why you need her phone number!" why the patient starts throwing a tantrum, flailing and screaming, "Leave me alone! Leave me alone! Leave me alone!"Now there were a lot of other people in the room, who started getting agitated as well.

Seeing as we run crews of three, a lead, a driver, a third, and this go we had a probie, for a grand total of four, there were just enough ruffians in the room so my crew could have just gotten away with a man-to-man defense. Seeing as that setup only seems to work for the Jets, I needed to turn the tables in our favor. "Medic to Base, can we get a PS officer up here?" "10-4, he's on his way."

As the arguing escalated, I tried to deal with the patient and the rest of my crew dealt with everyone else. My partner taps me, "Want me to ask for a 10-50?" He's from Jersey. "A what?" I say. "911." replies he. Let's give me another thirty seconds. It seemed like hours before it happened,

In walks, like the shining figure of authority the square badge on his chest might imply, the Public Safety officer. My trusty partner starts explaining the situation to him. Everyone looks expectantly... unfortunately, it seems the HE doesn't speak English, oddly enough. So what does he do...? Picks up the phone, dials, and says, "Yeah, it's XXXXX, can you give me a sgt? Alright, bye."

Oy!

At this point, I'm thinking, 'OK, if we just grab the patient and go, we may get away with it. AMS is great. Under the protocols, that's not kidnapping. If she slugs me, great. I'll slug her back. If the friends get involved, it's a felony...' Happily, I put my brain in before I got out of bed this morning.


---And here I end the story--- Quick finish: The sarge walks in with a complement of five more officers and clears the room (finally!). So all that was left in the room was my half my crew (I sent the other half outside to wait with some of the officers) the sarge, another officer, and the patient. First the sarge talks to her. Then my partner, then the sarge, then me. Finally after a FIFTY-FIVE MINUTE on scene time, the poor soul jumps from her bed to our stretcher and we make boogie faster than mice on ice. Good times.



The upside: No one got hurt, no one got arrested, and no one got sued.
The downside: Looong on scene time, and people could have gotten hurt. Oh, and no one got arrested.


Brings up the questions, when do you handle the situation by yourself, when do you call for backup, when do you call for PD, and when do you run?

The way it was, I could have called for Public Safety the moment I walked off the elevator and started getting sass from the pt's friend. I could have called for an RMP as soon as the sassing friend got out of control. I probably should have gotten my crew out of that room rather than waiting for Public Safety to show up. But where would that have left us? The patient would have been restrained and probably booked, possibly her friends as well. I wouldn't want to do that to someone if I didn't have to, though it would have meant I would have initiated transport a LOT sooner.

I suppose I liked the way I handled this situation the most, but then I'm biased. I know a lot of people who would have liked to get in & get out, and wouldn't have the patience to talk a patient into coming with us. And in the event that this had been a real emergency, and not just a drunk, I would have probably liked to do the same. I know when I was working under someone else, we had a person O/D on an unknown medication (a story for a later day), and I was starting to request RMPs and the cavalry to force this person to the hospital when my partner (and the lead) told them to cancel. Boy that pissed me off. We were on scene there for about thirty minutes, all the while, I'm waiting for this person to collapse, seize, or go crazy while my partner tries to talk her down.

I suppose it's just a judgement call, as like any other, but remember what they teach you: First the safety of your self, then the safety of your partner(s), then the safety of the patient, and finally the safety of others.