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Cecile Garcia, Operations Manager
By
October 11, 2019

5 Steps to Calm Down a Combative Patient

Sometimes, patients are difficult to deal with. They may be upset, under the influence of alcohol or drugs, or having a mental health episode. Your event may have difficult patients - especially if participants are consuming alcohol or using drugs. So how should an on-site EMT behave when confronting a combative patient? 

1. Keep The Patient at Arm’s Length

Self-protection always comes first for EMTs. If a patient is irate, there is a chance that they will become violent. Give the patient room, especially if they are under the influence - their behavior may escalate quickly. Do not be afraid to call law enforcement over - they are trained in physical de-escalation.

2. Let Them Speak

A patient wants to feel heard. Listen to them and let them speak. They may not be kind, but it is in the EMT’s best interest not to stoop to their level.

3. Acknowledge What They Said

A patient’s demands may be unreasonable but it is best to address them in a calm manner. Do not yell back. Be a patient advocate but tell them the limits of your care. Just as a nurse would ask a doctor for clarification, an EMT can call an ambulance and paramedics for patient care that is out of the EMT’s scope.

4. Explain The Situation in Simple Terms

EMTs should speak to patients directly in simplistic terms with a calm and assertive voice. Medical terms can confuse the patient, so speaking in layman's terms is best. Diagnoses should not be given - only nurse practitioners and doctors can give diagnoses. Phrases such as “I suspect this happened” and “I’m doing what I can” should be used instead. Explain to the patient step-by-step what they’re doing to help. This process informs the patient and calms them down. 

5. Always Have Someone With You

Don’t go into a situation with an irate patient without having someone with you. If security or law enforcement are available, call them to the scene. If not, another EMT will do. Someone should be there to watch your back - literally and metaphorically. If your back is turned to grab supplies, another person can watch the patient. Your back-up is also there for legal documentation - they can speak for you in case the situation escalates and it is brought to a court of law. 

 

Remember - patients have the right to refuse care unless they are under the influence or a harm to themselves or others (suicidal or homicidal). They also don’t have the right to refuse care if it is court-mandated. When an adult patient is of sound body and mind, they can refuse care - even if doing so may result in their death. If they refuse, write down that you advised the patient on further treatment. They are required to sign a form stating that they are going against medical advice.

As an EMT, patient care is important but always remember that your safety comes first. If you are not safe, you cannot help provide care.

 

Check out our blog post on Keeping Risk Management in Mind When Planning An Event. If you have any more questions on how to address combative patients at your event, email us at safety@joffeemergencyservices.com.

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