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The 3 golden rules for handling drunk patients

In EMS there isn’t anything more frustrating than a screaming, punching or spitting person with acute alcohol intoxication

I’ve been assaulted by drunken patients more often than any other type of patient.

Sometimes there are warning signs; occasionally there are not. When the patient becomes that intoxicated, there is psychologically nothing to keep that person from staying in control. It really creates an unfair situation for EMS providers who are charged with managing the patient and prevent further harm from occurring.

Of course, that’s small consolation when you are on the receiving end of a screaming, punching, biting and spitting drunk patient. It’s all too easy to lose momentary control and become angry.

The next time you’re in this situation, take a deep breath and remember these key points to minimizing the risk of injury:

1. Don’t take insults and verbal abuse personally.

The patient is drunk, not you. You’re the professional, so make sure you act like one regardless of what the situation may bring. The patient doesn’t know you from Adam in his/her drunken state - and doesn’t care. Ignore any insults that come your way.

When in doubt, remember he is a patient, not a prisoner.

2. Make sure the patient is actually drunk.

Be sure to check that there are no medical conditions, like stroke or diabetes, that might be mimicking a drunken state.

3. Use physical restraints.

Physical restraints are important, for your protection as well as that of the intoxicated patient. If you use physical restraints, make sure the patient’s airway is protected.

And keep yourself clear and clean. Suction, emesis bag, and staying alert will help keep any vomit contained.

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of “EMT Exam for Dummies,” has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board.