[ARCHIVED THREAD] - Please delete (Page 1 of 2)
Posted: 1/4/2017 11:52:56 PM EDT
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The only time City EMS transports suicidal persons is if there's a medical need. If there's only been threats, then in the back of the car they go.
I will use an ambulance and soft restraints in certain situations though. Your case sounds like a deputy who didnt wanna transport |
| If they haven't taken anything or harmed themselves, then it's for Psych Cop. But most pawn it off on us. Then all they get is a social worker who refers them to a psychiatrist. & the circle starts again a week or two later. PD are the only ones in Texas that can place someone on a mandatory psych hold. Just depends on who you get & how close to shift change they are. |
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The only time City EMS transports suicidal persons is if there's a medical need. If there's only been threats, then in the back of the car they go. I will use an ambulance and soft restraints in certain situations though. Your case sounds like a deputy who didnt wanna transport This is what I was thinking. Wouldn't even consider it. These are rare here, but there is no reason they didn't haul his ass in. |
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If they haven't taken anything or harmed themselves, then it's for Psych Cop. But most pawn it off on us. Then all they get is a social worker who refers them to a psychiatrist. & the circle starts again a week or two later. PD are the only ones in Texas that can place someone on a mandatory psych hold. Just depends on who you get & how close to shift change they are. It was 1800. Shift change is 1630 I think. |
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90% of the time we take them. If they did anything such as injure themselves in anyway, we take them 100%.
Only exceptions are if the deputy is in a good mood or wants to go into town or still a young go-getter. Or if they are being violent assholes, but that is still 50/50 whether we take or not depending on whatever form of self injury they choose. For the suicidal "ideations" people, the vast majority of the time they go in the ambulance even if they really just need a taxi ride. |
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The two above answers the same way I would. They definitely go in. Had he actually taken the pills then it would lean more toward ambulance. Just threatening is definitely PD. You shouldn't have gone in without PD. That is absolutely correct, but out here we all know everyone(absolutely no excuse, we shouldn't have gone in) and I can't stop some of these people from being stupid so I just try and mitigate some of the risks. I don't know how familiar you are with volunteer units, but it's clown shoes all the way around with the occasional miracle save. |
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It was 1800. Shift change is 1630 I think. Quoted:
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If they haven't taken anything or harmed themselves, then it's for Psych Cop. But most pawn it off on us. Then all they get is a social worker who refers them to a psychiatrist. & the circle starts again a week or two later. PD are the only ones in Texas that can place someone on a mandatory psych hold. Just depends on who you get & how close to shift change they are. It was 1800. Shift change is 1630 I think. Then he DEFINITELY didn't want to sit on a psych/suicide. Just the way EMS is. We are the only ones that can't say no.  I love asking the patient, "do you want to go to the ER? Or to somewhere there are counselors to help you with this?" the Cops hate that. Lol. Yet, they can pull the ol', "Hospital or jail? Which do you prefer?"
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I was a volly for 5 years before the 15 as a PM on a large FD. My experience is guys like you keep several of the others from killing themselves or others.
I get the going in thing and earlier in my career I used to go in when it sounded innocuous but I've had some shit go down enough that I don't do that any more. |
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The two above answers the same way I would. They definitely go in. Had he actually taken the pills then it would lean more toward ambulance. Just threatening is definitely PD. You shouldn't have gone in without PD. This. I know I'm preaching to the choir here, but suicidal people are homicidal. Act accordingly. |
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I was a volly for 5 years before the 15 as a PM on a large FD. My experience is guys like you keep several of the others from killing themselves or others. I get the going in thing and earlier in my career I used to go in when it sounded innocuous but I've had some shit go down enough that I don't do that any more. I want to quit this shit so bad, I truly don't care about most of these people. The adrenaline rush doesn't come anymore. I don't have flashy lights on my pickup and I don't wear department clothing except for the one day we take pictures. |
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Psychiatrists ARE MDs. That IS medical. Take 'em to the E.R. for a psyc referral. Edit: just like you would haul a probable ankle sprain for an X-ray and orthopedic refferal. I wouldn't haul an ankle sprain in unless it was a senior citizen that had no transportation. I'd let anyone else haul them in. |
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This. I know I'm preaching to the choir here, but suicidal people are homicidal. Act accordingly. I explained that to the dumbass firemen that showed up in the POVs right before I got there and were going to go in. And the ambulance showed up with only the driver, no EMTs, right as I pulled up. You all have no idea how fucked up rural EMS can be. |
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I want to quit this shit so bad, I truly don't care about most of these people. The adrenaline rush doesn't come anymore. I don't have flashy lights on my pickup and I don't wear department clothing except for the one day we take pictures. Volunteer? Quit. Seriously, it'll be better for you and yours, and that is what counts. If you don't like it, don't do it. |
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Expound, please. Quoted:
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Psychiatrists ARE MDs. That IS medical. Take 'em to the E.R. for a psyc referral. Lol. No Expound, please. They absolutely don't need to take up an ER bed unless they have harmed themselves. They need to go to a psych facility. Most ER' s don't have psych consult. They get a social worker or call a CIT/MHOfficer to take patients to a facility. |
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They absolutely don't need to take up an ER bed unless they have harmed themselves. They need to go to a psych facility. Most ER' s don't have psych consult. They get a social worker or call a CIT/MHOfficer to take patients to a facility. Idk how texas works, but up here, they have to go to a ER first to be medically cleared before they can be transported to a psych specific location. |
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Ok, I'll play.
In the county where I work PD in suburban Philadelphia, EMS be it paid or volunteer, is usually requested to the scene of any suicidal patient. If they have done harm, its an EMS transport with a PD assist if requested, everyone involved is allowed to use their best judgment and safety concerns trump all others. If the patient wants help and is willing to go to a crisis center, EMS will transport. If they do not want help but we have grounds to force them into help, PD will usually take custody unless they have already made the attempt to hurt themselves in which case they go to the nearest hospital for medical clearance before going to the crisis center. My county is also unique in that it has an ambulance staffed solely for the transportation of those in mental health crisis to the main county inpatient crisis facility for evaluation and treatment. This specialized ambulance responds to all area hospitals and residences (with PD assistance) for the service of voluntary and involuntary committals. It is not usually used as a first due emergency responder to 911 crisis incidents. This service is one of very few in the country like it. I'm a 5 year cop, 9 year EMT (5 of which were spent working whole or part time on that crisis ambulance). |
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They absolutely don't need to take up an ER bed unless they have harmed themselves. They need to go to a psych facility. Most ER' s don't have psych consult. They get a social worker or call a CIT/MHOfficer to take patients to a facility. So, that is where you are. Here, they get a consult. Any MD can make a consult. |
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So, that is where you are. Here, they get a consult. Any MD can make a consult. Quoted:
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They absolutely don't need to take up an ER bed unless they have harmed themselves. They need to go to a psych facility. Most ER' s don't have psych consult. They get a social worker or call a CIT/MHOfficer to take patients to a facility. So, that is where you are. Here, they get a consult. Any MD can make a consult. Very well. It still isn't a medical call requiring an ambulance or an ER bed. |
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Very well. It still isn't a medical call requiring an ambulance or an ER bed. Quoted:
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They absolutely don't need to take up an ER bed unless they have harmed themselves. They need to go to a psych facility. Most ER' s don't have psych consult. They get a social worker or call a CIT/MHOfficer to take patients to a facility. So, that is where you are. Here, they get a consult. Any MD can make a consult. Very well. It still isn't a medical call requiring an ambulance or an ER bed. This guy had a handful of Tylenol that he kept calling painkillers. Like 1600 mg. He was no threat to anyone unless he fell on them...He's over 350. Thank God he could walk. |
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This guy had a handful of Tylenol that he kept calling painkillers. Like 1600 mg. He was no threat to anyone unless he fell on them...He's over 350. Thank God he could walk. Quoted:
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They absolutely don't need to take up an ER bed unless they have harmed themselves. They need to go to a psych facility. Most ER' s don't have psych consult. They get a social worker or call a CIT/MHOfficer to take patients to a facility. So, that is where you are. Here, they get a consult. Any MD can make a consult. Very well. It still isn't a medical call requiring an ambulance or an ER bed. This guy had a handful of Tylenol that he kept calling painkillers. Like 1600 mg. He was no threat to anyone unless he fell on them...He's over 350. Thank God he could walk. I know the feeling. |
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Oh, we still take them. It's just a waste of a resource. Especially if a deputy has to follow you back. We didn't even put him on the gurney. I just seat belted him into one of the side seats. I didn't want to have to replace the sheets and sanitize everything. |
| About 50-50 here, hospital has a psych-ward so EMS will transport if they are compliant and want to be transported or there is underlying medical stuff. If they want us to transport them or have potential to be combative we transport. Non-compliant/combative and they get the polyester-party. |
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I want to quit this shit so bad, I truly don't care about most of these people. The adrenaline rush doesn't come anymore. I don't have flashy lights on my pickup and I don't wear department clothing except for the one day we take pictures. Then it is time to go. When you truly don't care about the patient then bow out. I had to 3 times. Third one was final. You become a liability to the patients and more importantly, yourself. |
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Then it is time to go. When you truly don't care about the patient then bow out. I had to 3 times. Third one was final. You become a liability to the patients and more importantly, yourself. Being a volly I can be a little bit selective. I'm not a liability yet, but 2 years from now I can see that being a problem. Half the problem is the dipshits on the squad and completely untrained firemen that we have to deal with. Most of the FD has never been to any training other than the required CPR class. |
| The only one I dealt with on a volunteer fd was fortunately a small woman. She kept arguing that she had the right to end her life and had supposedly taken a whole bottle of antidepressants. I came close to asking an attending police officer to place her under arrest but knew the Chief of Police, who was also over the FD might get mad having to give up an officer to stay with her at the hospital. Fortunately, the Chief showed up and said it was ok to make her go. She fought and I held her down and got her strapped on to the stretcher. Don't know what happened to her after that, but found out later she was a regular call due to mental illness. |
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I was a volly for 5 years before the 15 as a PM on a large FD. My experience is guys like you keep several of the others from killing themselves or others. I get the going in thing and earlier in my career I used to go in when it sounded innocuous but I've had some shit go down enough that I don't do that any more. This. EMS around here stages and waits for us to give the all clear. I've had several hairy situations that EMS would have gotten hurt in had they rushed in first. Unless you're armed and trained, don't do it. |
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I want to quit this shit so bad, I truly don't care about most of these people. The adrenaline rush doesn't come anymore. I don't have flashy lights on my pickup and I don't wear department clothing except for the one day we take pictures. I get where you're coming from. I tell people, "I love being a paramedic, I hate EMS." I wouldn't do my job for free, but they pay me pretty well for what I do and I get to ride the big red truck every now and then. That's why I still do it. I don't get why people volunteer to be EMTs. I get why people do the volly FF thing, but EMS sucks balls. |
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I get where you're coming from. I tell people, "I love being a paramedic, I hate EMS." I wouldn't do my job for free, but they pay me pretty well for what I do and I get to ride the big red truck every now and then. That's why I still do it. I don't get why people volunteer to be EMTs. I get why people do the volly FF thing, but EMS sucks balls. EMS responders only have so many calls in them. Some people have enough they can make a career out of it. I got to the point I'd get back to my house, sit on the front steps and cry until I could get myself together sometimes and go back in to my family where they wouldn't see. I knew I was close to my limit at that point. Blew out a knee, then had health problems with parents, so I was able to leave without much guilt. |
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"I wouldn't really care if he took the pills or not" Why the fuck are you doing that job then? Because someone has to do it. I was the first EMT on our squad. That was in 2002. They had been a first responder squad until then, relying on other towns to transport. I had high hopes for what could be done back then. Now I know that it is never going to happen. And I wouldn't take my 10 yr old son to the ER if he had actually taken a handful of tylenol. |
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I get where you're coming from. I tell people, "I love being a paramedic, I hate EMS." I wouldn't do my job for free, but they pay me pretty well for what I do and I get to ride the big red truck every now and then. That's why I still do it. I don't get why people volunteer to be EMTs. I get why people do the volly FF thing, but EMS sucks balls. If it was all traumas, I'd love it. I'm sure you know better than I do, but 90% of the medical calls are total bullshit. They're either an elderly person that just wants company or some white trash person looking for meds. |
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Idk how texas works, but up here, they have to go to a ER first to be medically cleared before they can be transported to a psych specific location. Quoted:
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They absolutely don't need to take up an ER bed unless they have harmed themselves. They need to go to a psych facility. Most ER' s don't have psych consult. They get a social worker or call a CIT/MHOfficer to take patients to a facility. Idk how texas works, but up here, they have to go to a ER first to be medically cleared before they can be transported to a psych specific location. Not sure why a suicidal ideation with no action would need a medical or traumatic evaluation. |
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Where I'm at, local/county Fire/EMS will not take them under any circumstances (aside from if they've already attempted and need medical treatment).
Either county deputies (if they're violent/visibly agitated) or a private ambulance service will take them to the county mental health treatment center for a voluntary/involuntary 72hr. hold. ETA: No vollies in my area, all full time departments. |
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Because someone has to do it. I was the first EMT on our squad. That was in 2002. They had been a first responder squad until then, relying on other towns to transport. I had high hopes for what could be done back then. Now I know that it is never going to happen. And I wouldn't take my 10 yr old son to the ER if he had actually taken a handful of tylenol. Quoted:
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"I wouldn't really care if he took the pills or not" Why the fuck are you doing that job then? Because someone has to do it. I was the first EMT on our squad. That was in 2002. They had been a first responder squad until then, relying on other towns to transport. I had high hopes for what could be done back then. Now I know that it is never going to happen. And I wouldn't take my 10 yr old son to the ER if he had actually taken a handful of tylenol. If a 10 year old eats a handful of of Tylenol they need to go to the ER. |
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Not sure why a suicidal ideation with no action would need a medical or traumatic evaluation. Wisconsin has what's called a Chapter 51, an involuntary detention for those who are either suicidal or homicidal. Local hospitals typically don't house people on Chapter holds. So when they get sent to a secure facility, they need to be medically cleared before being transported. Not everyone who is suicidal is chaptered, there is specific criteria. |
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If it was all traumas, I'd love it. I'm sure you know better than I do, but 90% of the medical calls are total bullshit. They're either an elderly person that just wants company or some white trash person looking for meds. Put the pager away for three months and see if you want to come back. I bet you don't. Nothing wrong with that. |
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Wisconsin has what's called a Chapter 51, an involuntary detention for those who are either suicidal or homicidal. Local hospitals typically don't house people on Chapter holds. So when they get sent to a secure facility, they need to be medically cleared before being transported. Not everyone who is suicidal is chaptered, there is specific criteria. Quoted:
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Not sure why a suicidal ideation with no action would need a medical or traumatic evaluation. Wisconsin has what's called a Chapter 51, an involuntary detention for those who are either suicidal or homicidal. Local hospitals typically don't house people on Chapter holds. So when they get sent to a secure facility, they need to be medically cleared before being transported. Not everyone who is suicidal is chaptered, there is specific criteria. Copy that. Ours is called title 47 (state law). Suicidal Ideation with no indication of attempt goes to the Psych ED. I guess I'm splitting hairs here because we take them to the psych ED which is attached to the regular ED. It is staffed with Psychiatrists a psychiatric nurses. They don't take up a standard ER bed. Then they can be transferred to the actual longer term psychiatric hospital which we don't transport directly to under title 47. Almost all of these calls I can turf the transport to psych ED to the cops if the patient hasn't taken any action (SI only). |
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I didn't know there were volunteer EMS. I'm a newbie, but our Search & Rescue is all volunteer (most are). The Sheriff's Office won't dispatch us if someone is believed to be suicidal, because, as was stated, they are considered homicidal. One nice thing though is that after a year in the unit, we can pass the SO's test and carry while on call. We had a situation recently with the belligerent father of a lost kid and let's just say that concealed means concealed. ETA: Answered above while I was typing. |