Scene safety and psychotics

Last night, there was a patient who called 911 and told dispatch that he thought someone had poisoned his drink. Now we get people who are mildly paranoid pretty frequently, but this one was different. The transport medic on this run thinks he has ten years experience. He has been on the job for two and a half years, but actually has one year of experience that he repeats over and over, because he learns nothing. Paramedic George has been precepted three times.

There was a couple on scene who told us that our 20 year old patient had a history of psychosis, had not taken his meds in weeks, and was on this night convinced that his parents were working with a demon to try and poison him. When I joined paramedic George in the back of the rig, the patient was already showing signs of aggression: he was trying to stare each of us down. Domination games. His thoughts are rambling between asking where his parents are, to making statements about how we are all doomed because Satan is coming.

By the time we get to the hospital, his statements have evolved to saying things like, "You are going to beat me up, aren't you? You know you want to. WE both know where this is headed, so lets just get it over with."

By then, there are 8 of us there, including the hospital staff. I look over at George, and he is standing in front of the patient, within arms reach, and is stretching and yawning with a full on, open mouthed, eyes closed yawn. The patient bowed up to fight, and an ER medic and myself jumped him before he could move. We wound up holding the patient down for some Haldol and some leather restraints.

Some people just never learn.