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Behind the Patient: Street Portraits
by Michael Morse

5 crazy but common EMS scenes and how to manage them

Things tend to improve when a competent person with a plan arrives on scene

By Michael Morse

Not all responses go as smoothly as we would like.

People have different thresholds for coping with things that frighten, confuse, or worry them. Objectivity is imperative at an emotional scene; people need somebody to take charge and lead them out of the jungle that has invaded their space.

An emergency scene can be returned to order simply by not participating in the nuttiness. The trick is to calmly, and non-judgmentally try to make things better by finding out what is wrong, solving the problem and getting the right resources to the scene.

Here are five scenes that could easily get out of control, and how to handle them:

1. A dead body in a bedroom

For some weird reason people (myself included) feel better when a person in an official capacity arrives and begins sorting things out. There is no manual for when a person dies at home; even the best hospice programs seldom fully prepare a family for the end. In this situation, it’s best to act like the official the family needs. A simple “I’m sorry for your loss” works wonders. “Is there clergy you can contact?” is also good. “I’ve contacted the proper people, they will help you through this,” will begin the calming down phase. Now that the crisis is over, the healing can begin.

2. A sick child

Treating the child like your own works wonders when the family is concerned. I’ve never seen a troubled scene calm down faster than when I gently put my hand on a feverish kids forehead.

3. An out-of-control argument

The cause of the argument is none of my concern. Separating the arguers is and assessing the severity of the ensuing panic attack is. I’ve never solved an argument that had nothing to do with me and probably never will.

4. A person with a gun threatening to kill himself and/or everybody else

Now is a great time to leave the building, taking whoever will come with you, break the rules, and call the cops.

5. A heart attack

Getting right down to business gives the hostile crowd something to focus on. I like to give one or two of them jobs such as clearing a path, opening doors, or my favorite, holding the IV bag. It keeps their hands full, and most people who don’t deal with emergencies for a living are absolutely petrified of breaking or somehow screwing up the line, or dropping the bag.

Focusing on the solution rather than the problem works almost every time. Even when it doesn’t, things tend to improve when a competent person with a plan arrives on scene. 

About the author

Michael Morse is a retired Rescue Captain with the Providence (RI) Fire Department. He is the author of the books Mr. Wilson Makes it Home, Rescuing Providence and Responding. His columns appear in numerous fire and EMS publications and the Providence Journal. He can be reached by email to Michael Morse
The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Sam IAm Sam IAm Saturday, August 16, 2014 1:49:48 PM Had 'em all, and a lot more...
Israel Larue Israel Larue Saturday, August 16, 2014 2:38:30 PM So today I saved a womens life when I happen to take a gravel road and drove apon a car rolled over in the ditch with a ladie yelling for help.. so I ran up to here and told her not to move and call 911 as I waited for fire and ems to arive I climed in the back seat and braced her head so she wouldnt move and talked to her to calm her down l. Then fire dept rolled up and seen that I was braceing her head and asked me if I was a firefighter or emt and I said no. Hes comeback was. YOU SHOULD BE.. I said someday I will be and so I got out the way and stood by and helped with what I could glad to say she will be fine. Just a broken leg and arm.. si glad I took that gravel road..#firefighter #ems #goodSamaritan #iknowmybasic
Sandy-Rose Milkert-Burke Sandy-Rose Milkert-Burke Sunday, August 17, 2014 9:51:03 AM Only one I haven't dealt with is the gun/ threat to kill one. Somehow I am at peace with dealing with that anyway. Because I know the regs and I will do it b y the book.

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