How to handle the "crazies"

Da_Milk_of_Amnesia, MSN · Oct 22, 2009

If he's a drunk, 25mgs of phenergan should kill 2 birds with one stone. It'll should shut him up and stop him from puking. Easily Solution for an easy problem. Just make sure to roll him to either side just incase of course hahaha lol jkjk

inteRN · Oct 22, 2009

HAHA!! Thats awesome...just tell him its that "pain med" they've been begging for huh? Thanks!!

Da_Milk_of_Amnesia, MSN · Oct 22, 2009

In all seriousness tho...I deal with drunk people in ambulances and I explain things twice (Mayyyybe 3 times but NO MORE) and thats it's..ever try arguing with your significant other when they are drunk? Yeaa it doesn't go over to well, so it's the same thing here, altho we can't yell and scream and use awesome 4 letter words.

But when someone asks the same question a bunch of times it tries my patience and I tell them after the 3 time that I've already answered the question and I'm not going to answer it anymore. If they decide that its a good idea to get rowdy, no problemo...SECURITYYYYY, Or whie in the back of an ambulance it's restraint time....because it's not my job to sit there and hold their hand or be their friend. I'm here to make sure you don't die from being a moron.

And If i had it my way, I'd let the dumb teenager/ underage kid sit there and deal with it. Everything in life has consequences...You made the decision to drink now you can deal with the consequences of being a moron n having too much.....because all we do when we bring them to the ER is we perpetuate a cycle and these kids think it's ok to get smashed because the hospital will make it like it's never happened. BS!

And as for the psychs and the 'cry-for-help' attempted suicides...I'm not gonna get into because I'm liable to offend alot of people

I'm extremely jaded from doing EMS for so long so I'm probably not the best person to be giving out advice on certain things...this being one of them...I just try to laugh and make sure the bastard does not puke on me or inhale his own puke, if you do that then you should be fine. In the hospital restraints are the last option, technically using phenergan in the way I stated above would be using it as a chemical restraint both of which are 'no no's'

all you can hope for is that they are soo boozed up that they just sleep and if they don't throw a liter bag in a pillow case and given them a whack upside the skull, that'll def put him into a state of unconsciousness hahaha

getoverit, BSN, RN, EMT-P · Oct 22, 2009

I know what you mean.

Honestly, I stay agreeable toward them and I'm sure you do too. A big lesson to learn (and one that took awhile for me) is to know when there's absolutely no point in arguing with someone...which is true most of the time in general, especially with patients like you described.

If they ask repetitive questions I'll give them repetitive answers as long as I'm in the room with them. If they start yelling I tell them to stop, when they don't I'll close the door whenever possible, as long as there's no safety issues in doing so.

If they are truly "crazy" and doctors have decided to withhold their meds for clinical reasons.....then you pretty much have to think about whatever makes you happy and remember that you're going home in a few hours but some unlucky person probably has to spend the rest of their life with the person....which probably ain't much fun.

Hope your next shift is better and these things will always come and go, they make for good stories later on.

LeedsIrish · Oct 22, 2009

Grew up in a pub, (working behind the bar, not on the other side I hasten to add), so dealing with drunken loons has been a feature of my life for as long as I can remember. A day without some sort of drunken shenanigans is pretty much like a day without sunshine for me! "In one ear, out the other" is my own personal philosophy...it's served me well...never lose your cool, and always try to see the funny side...usually quite entertaining, if you can step outside the situation!

guy_nurse · Oct 22, 2009

The first thing I do is cut their clothes off, period, it just makes it easier.

Drunk=large bore IV-at least 18g, rally pack, foley catheter (you've got to get a urine sample, right), some restraints (because they ARE going to try and remove the foley-trust me, don't ask), and ask the attending if you can have some drugs if they are still too roudy.

OD=call to posion control, large bore IV, usually charcoal-I give the option to drink it, or we can put a tube down and get it in that way--oh yes we can! If they choose to not drink it-restraints, NG or gastric lavage (now that is fun-NOT), foley, and petition the doc for some drugs.

May sound harsh, but I work with a nurse that PRNs at a military base and they say that it is not uncommon for docs to intubate drunk solders until they sober up.

AngelfireRN, MSN, RN, APRN · Oct 22, 2009

EMTRN, I'd like to hear your tales about the cry-for help crowd. You can PM me if you want, and you WON'T offend me. Been there and done it for too long!

Editorial Team / Moderator · Oct 22, 2009

May sound harsh, but I work with a nurse that PRNs at a military base and they say that it is not uncommon for docs to intubate drunk solders until they sober up.

I had a pt recently with a BAL of 567. Epic! LOL. He came *thisclose* to getting tubed -- he had the barest of gag reflexes, but did okay with the nose hose I placed. He ended up in the ICU because his risk of aspiration was so high.

cjthegreat · Oct 23, 2009

My patient with a BAL of 560 a few weeks ago did buy himself a tube. He also had a core temp of 93 degrees. Hooray for the cold weather and alcohol!!

HumptyDumpty · Oct 27, 2009

EMTRN, I'd like to hear your tales about the cry-for help crowd. You can PM me if you want, and you WON'T offend me. Been there and done it for too long!

I second this, I would love to hear some stories as well. I have a feeling I have the same perspective as you.