An EMS approach to psychiatric emergencies

Psychiatric patients present challenges not only to EMS, but in the ED as well. As we have tried to indicate in the case report, the presentation is not always clear-cut. There may not be a definite solution, and each case can be different. As an EMT or paramedic, how should you approach these issues? First, always make sure the scene is safe for you and your team. If you have doubts, contact law enforcement. With regard to patient care, err on the side of safety and what is in the best interest of the patient (which may include restraints). Follow established procedures and guidelines, and always document well. If you have any questions on scene, contact medical control, and document doing so. If there is a question, let the physician decide on competency issues.