August 2009 Calendar ModuleAugust 2009 Calendar ModuleNear-Miss EMS IncidentsNear-Miss EMS Incidents

Photo Courtesy: Jason R. Henske/fyrfoto.com

Incident #1Incident #1

Call received for a patient with an Call received for a patient with an altered mental status.altered mental status.

Crew arrives and encounters an Crew arrives and encounters an elderly female who appears to be elderly female who appears to be confused.confused.

Crew begins treatment of patient.Crew begins treatment of patient.

Incident #2Incident #2

Call received for a diabetic Call received for a diabetic emergency.emergency.

Crew arrives and finds an elderly Crew arrives and finds an elderly male sitting in a recliner.male sitting in a recliner.

Assessment and treatment of patient Assessment and treatment of patient begun.begun.

Incident #3Incident #3

Call received for a patient with Call received for a patient with difficulty breathing.difficulty breathing.

Crew finds elderly male in respiratory Crew finds elderly male in respiratory distress.distress.

Patient had a history of COPD.Patient had a history of COPD. Home oxygen supply was exhausted.Home oxygen supply was exhausted. Patient requested oxygen therapy only, Patient requested oxygen therapy only,

did not wish to go to the hospital.did not wish to go to the hospital.

Incident #3Incident #3

Crew advised patient he needed to be Crew advised patient he needed to be transported.transported.

Patient became upset, stated his Patient became upset, stated his desire to not be transported.desire to not be transported.

Crew spent nearly an hour with the Crew spent nearly an hour with the patient.patient.

Patient calmed down, eventually Patient calmed down, eventually consented to be transported.consented to be transported.

Things in CommonThings in Common

All:All: were legitimate medical emergencieswere legitimate medical emergencies patients were elderlypatients were elderly incidents occurred at the patients’ residences incidents occurred at the patients’ residences crews handled the incidents without assistance crews handled the incidents without assistance

from the police initially from the police initially

Questions to PonderQuestions to Ponder

Would you suspect violence in any of Would you suspect violence in any of the incidents?the incidents?

Would you request police assistance?Would you request police assistance? If so, would you stage until the police If so, would you stage until the police

arrived?arrived?

Remember the BasicsRemember the Basics

Scene safety!!!Scene safety!!!

A ReviewA Review

Incident #1 – Confused elderly Incident #1 – Confused elderly femalefemale

Incident #2 – Elderly male, diabetic Incident #2 – Elderly male, diabetic emergencyemergency

Incident #3 – Elderly male, difficulty Incident #3 – Elderly male, difficulty breathingbreathing

Crew ActionsCrew Actions

Nothing in any of the incidents gave Nothing in any of the incidents gave the crew an indication of potential the crew an indication of potential violence.violence.

Crews did not request police Crews did not request police assistance.assistance. Police arrived on one incident, Police arrived on one incident,

presumably as part of a routine responsepresumably as part of a routine response

Crews entered residences without Crews entered residences without police presence.police presence.

Your Actions?Your Actions?

Would you have done anything Would you have done anything differently?differently? If you answered honestly, probably not.If you answered honestly, probably not.

The Rest of the Story!The Rest of the Story!

Incident #1Incident #1

Crew treats the patient for confusion Crew treats the patient for confusion without incident.without incident.

They assist her in walking out of the They assist her in walking out of the house to the ambulance.house to the ambulance.

She stops suddenly and wants to She stops suddenly and wants to retrieve something from the corner of retrieve something from the corner of the couch.the couch.

Crew continues to walk her to the Crew continues to walk her to the ambulance.ambulance.

Incident #1Incident #1

Deputy arrives on location, was asked Deputy arrives on location, was asked to check couch for what patient to check couch for what patient wanted to retrieve.wanted to retrieve.

Deputy returns to the ambulance and Deputy returns to the ambulance and advises crew he found a loaded advises crew he found a loaded handgun under a cushion on the handgun under a cushion on the couch.couch.

Crew advised it was the same area Crew advised it was the same area where the patient had stopped.where the patient had stopped.

Incident #2Incident #2

Crew begins to treat patient for his Crew begins to treat patient for his diabetic condition.diabetic condition.

Patient reaches in side pocket of Patient reaches in side pocket of recliner and pulls out a handgun.recliner and pulls out a handgun.

Crew immediately exits the residence Crew immediately exits the residence without incident and awaits arrival of without incident and awaits arrival of police.police.

Incident #3Incident #3

Crew treats patient with oxygen for Crew treats patient with oxygen for nearly one hour.nearly one hour.

Tries to convince him to go to the Tries to convince him to go to the hospital.hospital.

Calms the patient when he becomes Calms the patient when he becomes agitated.agitated.

Eventually transports patient without Eventually transports patient without incident.incident.

Incident #3Incident #3

Crew later receives telephone call Crew later receives telephone call from their dispatch center.from their dispatch center.

Dispatch center advised patient Dispatch center advised patient became agitated at the hospital and became agitated at the hospital and pulled a handgun.pulled a handgun.

Patient actually discharged the Patient actually discharged the weapon and shot a piece of weapon and shot a piece of equipment. equipment.

Follow UpFollow Up

Violence was not suspected on any of Violence was not suspected on any of these incidents, however;these incidents, however; a lethal weapon was produced on each a lethal weapon was produced on each

incident andincident and the potential for tragedy was obvious.the potential for tragedy was obvious.

Actions of the CrewsActions of the Crews

The crews mentioned in these incidents The crews mentioned in these incidents averted tragedy byaverted tragedy by quickly leaving the scene when a weapon was quickly leaving the scene when a weapon was

produced;produced; maintaining awareness of their surroundings;maintaining awareness of their surroundings; not allowing patient to retrieve objects; andnot allowing patient to retrieve objects; and displaying compassion and concern for the displaying compassion and concern for the

patient.patient.

Lessons LearnedLessons Learned

Always remain aware of your Always remain aware of your surroundings and actions of the surroundings and actions of the patient.patient.

Trust your instincts.Trust your instincts. A “routine” call can quickly turn A “routine” call can quickly turn

dangerous. dangerous.

Be Safe Out There!!!Be Safe Out There!!!