This month, Facebook users chime in on “EMS Providers Should Train like Fighters,” a JEMS.com article by fitness columnist John Amtmann, EdD, on why it’s important for EMS providers to train for the worst-case scenario. Would you be prepared to defend yourself? Also, users share feedback on a March JEMS article by Bryan Bledsoe, DO, FACEP, FAAEM, on EMS in the Pennsylvania Amish community (“Simple Way of Life: EMS in Amish country”).
I definitely think we should be prepared for any harmful situation. I was involved in a situation that went bad fast. I was assaulted by a patient who was on numerous illegal drugs. Initially, he presented with hypoglycemic symptoms, but after loading him into the unit, he began to exhibit signs of paranoia and hallucinations. Luckily, the police department was on scene, but unfortunately he had a chance to grab me.
It took the fast thinking of the officer to physically make him release his hold on me, and for my partner to administer Versed, which did absolutely nothing, to get me freed. It happened so fast, so I agree that it would have been helpful if I’d known some self defense. That way, I would have known how to break the death grip he had on me when he wrapped his legs around me, without injuring him. He not only physically harmed me, but he also made me lose the trust I had prior to that day.
Like I was taught, I don’t plan to fight; I plan to end it. And I’m not referring to irrational, overdose or dementia patients. I’m referring to the rational patients who might turn on us one day. Everyone is always happy to see EMS. Cops are always immediately on hand and helpful, and happy endings are guaranteed, right? The truth is, you never know when something might happen. I believe in doing no harm first and foremost. I also believe in coming home safe and in one piece after every shift.
Heather Gaff Mewis
While I was responding to a code orange (a suicidal psych patient), who had just been struck by a vehicle in an attempt to take his life after assaulting his mother in her home, police and sheriff were on scene as my unit arrived. I’ve done mixed martial arts for a few years, and when three law enforcement officers and one of my two partners couldn’t restrain the patient, I fell back on my own training to ensure scene safety by doing what the rest on scene couldn’t.
I wrapped the patient up in a Brazilian Ju Jitsu hold. Once I had him fully restrained, the officers assisted in putting restraints on the man while they systematically strapped both me and the patient to the backboard. After we were both strapped in and he was much better restrained, they loosened one strap at a time, so I could slip my limbs out and prepare the patient for transport. If a patient’s aggression causes this kind of situation, knowing how to defend yourself is literally a lifesaver.
As a former EMT with Lancaster EMS as well as Strasburg EMS, I’ve worked with several of the Amish EMTs, and I must say they’re very dedicated and caring for the entire community—not just their own people. The area that they cover is a large tourist area, and they work well with people from all over the country and from all walks of life.
However, treating the Amish themselves can be a real challenge. I ran on a call for a child with a traumatic injury after being kicked by a horse. My partner and I wanted to fly the child to a nearby hospital, but the family said ‘no helicopter; just take the patient to the hospital and let God decide the outcome.’ As a healthcare provider, sometimes they do tie your hands as far as treatment and transport go.
I work in northeast Indiana, and we have a large Amish population. We have a very good relationship with them, perform occasional safety days for them and have several medics who travel to Amish schools with an ambulance to interact with the kids. We have several EMTs and medics who grew up Amish, which is helpful for speaking with the young kids who don’t speak English. As mentioned, there are sometimes differences in opinions, as far as flying patients (they strongly prefer not to use the helicopter), and they definitely don’t call unless things are very serious. The one thing you can always count on, with the Amish, though, is that they’re very grateful for our help and are supportive of what we do.
This article originally appeared in May 2012 JEMS as “Letters: In Your Words.”