Clinical scenario: Police with a psychiatric patient

Police have tasers ready for an agitated man pacing back and forth and sweating — what’s your course of action?

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While staffing Rescue 6, you are dispatched to a report of police on scene with a psychiatric patient. You are sent non-emergency, but en route are asked by dispatch to upgrade. On the scanner you hear the officers on scene requesting additional resources. 

As you arrive, you count five police cars. The officers are in the street near the corner where one appears to be talking to an approximately 45-year-old male. Several officers have their Tasers out and are instructing the patient to lie down on the ground.

The patient is pacing back and forth, appears agitated and is speaking rapidly. He is visibly sweating and is wearing only underwear despite the temperature being in the low 40s. 

One of the officers approaches your vehicle and tells you that the patient’s wife called when she arrived home to find him pacing around the living room speaking incoherently. The patient has no psychiatric history and is only medicated for hypertension. 

When contacted by the first-responding officers, he ran through the back door of the home. A foot pursuit ensued until the patient was cornered at the current location. 

Based on the limited information available, what is your working diagnosis?

What are some important considerations when responding to these types of situations?

What is your suggested course of action?

Post your comments below, and stay tuned for the conclusion of the case next week.

About the author

An EMS practitioner for nearly 15 years, Patrick Lickiss is currently located in Grand Rapids, MI. He is interested in education and research and hopes to further the expansion of evidence-based practice in EMS. He is also an avid homebrewer and runner.

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