Police dragged EMT Deannah Williams, who was repeatedly punching a patient, out the side door of the ambulance. The male patient, 17, was handcuffed and restrained at the ankles.
Williams alleges he spit on her. There is something uniquely dehumanizing about being spit at by a patient.
“Spitting in someone’s face is probably considered one of the worst things you can do,” said Ross Coomber, a professor with an interest in the sociology of spitting. “It’s obviously a form of violence, very confrontational, perhaps the most violent you can be against someone without actually hitting them.”
We’ve all had patients provoke us because they are alcohol intoxicated, high on drugs, experiencing a behavioral emergency, or have malicious intent to cause injury. Meeting violence with violence is inexcusable, but what can we learn by watching WIlliams’ expletive-laden attack?
Here are four questions to discuss with your personnel about reacting to a spitting attack, policies for treating restrained patients, co-responding with law enforcement and implementing body-worn camera:
1. What situations require a police officer inside the patient care compartment?
Watching the police officer’s body-worn camera video it’s not clear if there is a police officer in the ambulance with the handcuffed patient when Williams begins punching. The presence of law enforcement is the first level on Kelly Grayson’s EMS use of force continuum.
2. How do you teach personnel to recognize the triggers of their personal rage meter?
Each of us responds to provocations differently and we need to have self-awareness about our triggers, strategies to recognize those triggers and mechanisms to prevent our rage meter from entering the red zone. Self-defense, says Steve Whitehead, starts with recognizing you are being attacked.
3. What training do personnel receive to stop or redirect an out-of-control co-worker?
While Williams was throwing multiple punches another man, dressed like an EMS provider or student, stood at the foot of the stretcher. When the scene becomes unsafe he has a responsibility to the patient, as well as Williams, to make it safer for him, his partner and the patient.
4. Will EMS providers equipped with body-worn cameras react differently to patient provocations?
The police officer’s bodycam video is a compelling indictment of Williams’ behavior. Unfortunately we don’t have a BWC video from Williams’ point of view to know the events and communication leading up to the incident.
A 12-month BWC randomized trial investigated police officer use-of-force incidents. During the experimental period there was a precipitous drop in UOF incidents and citizen complaints. The research team observed:
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People tend to “adhere to social norms and change their conduct” once they’re aware that their behavior is being observed
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BWCs convey a pragmatic message – “you are being watched, videotaped and expected to follow the rules.”
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The “self-awareness effect” affects the psyches of officers and suspects alike, prompting suspects to “cool down” aggressive actions and deterring officers “from reacting with excessive or unnecessary force.”
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There’s a “training potential” in BWC videos. The footage “can be used to coach officers about how they conduct themselves.”
