Should law enforcement be securing patients before naloxone is administered?

Using restraints to protect a patient from harming themselves or providers is not new to EMS, but the circumstances are

On May 15, 2019, Appleton Fire Department (AFD) responded with law enforcement and an ambulance to a report of an unconscious patient at a bus station. The patient had not exited the bus when it arrived in the station and bystanders called 911, concerned that he had suffered a seizure. Arriving medical personnel suspected that the male was unconscious due to an overdose of opioids, and administered a dose of naloxone.

The patient quickly awakened and was reported to be confused, paranoid, angry and violent. Law enforcement attempted to get the patient to cooperate with EMS for further assessment and treatment, but he pulled a gun from under his shirt and started firing at responders. One of his shots struck and killed AFD Firefighter Mitchell Lundgaard. The shooter then grabbed a bystander and attempted to use her as a shield, but law enforcement shot him, stopping the assault. He later died in a local hospital.

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