Most people understand when police officers answer a call, they never know what will be found or if their lives will be in danger. But many don't think about the dangers faced by other first responders, especially medical personnel.
This week emergency medical technicians and paramedics with the Wilson Emergency Management Agency learned techniques to help them subdue people who need help but may be out of control and a danger to themselves and others.
"We've seen an upswing in violence against medical personnel. It's up 300 percent in the last two years," said WEMA Director John Jewell, adding that his agency has instituted a new policy that left his workers needing a way to protect themselves.
"I recently enacted a gun policy for the agency that medical personnel cannot go armed on calls," Jewell said. "It's too easy for someone to take a gun and use it on the person who was carrying it."
A trip to a recent seminar led Jewell to contact safety educators Charlene Watson and Joe Wyka about instructing his workers on a system they can use to restrain violent patients without doing them any lasting harm.
The pair visited WEMA on Thursday to demonstrate and teach the CDT method. CDT is a soft-handed control/restraint system that is easy to learn, maintain and apply. CDT was designed for real world situations to physically control or disarm a hostile aggressor and keep him or her in compliance or completely restrained until help arrives.
The technique was developed in 1992 and is based on the need for a proven system that focuses strictly on diffusion of a physical aggressor. Designed for law enforcement, CDT is now being implemented in hospitals, public and private schools, airlines, night-clubs and religious organizations.
CDT uses "soft hand" techniques that involve applying pressure with the hand to vulnerable areas of the body. Using simple moves, emergency personnel can render an out of control patient almost motionless until they can be restrained, stopping them from harming themselves or the people who are there to help them.
The elements of CDT are "Compliance," defined as diffusing an aggressive act through soft-handed control or restraint techniques in order to protect the safety and welfare of others; "Direction," defined as steering or moving an aggressor to a safe place or position in order to protect the safety and welfare of others; and "Take Down," a safe, non-vital method used to keep an aggressive subject in a prone position in order to secure and maintain them, or if legally allowed, to fully restrain them with handcuffs or restraints.
In plain terms, the technique allows emergency workers to use simple holds - a thumb to the cheek, a grip on the leg, that produces enough pain to stop a person from acting aggressively without injuring them.
"Size doesn't matter," Wyka said. "You grab them in a sensitive area. With a lot of small hospitals closing, larger hospitals have an increased volume of patients and extreme wait times. This has led to a new level of violence. When you add drugs like bath salts, it's also a new type of violence."
He explained the idea for emergency responders is just to control a violent person, whether they are upset by extreme pain or because they are taking drugs that alter their perceptions, until they can reach a hospital. The CDT method does cause the patient pain, but no permanent damage.
"When you let them go, there's nothing wrong with them," Wyka added. "You don't touch any vital organs, the throat or ears. There is just enough pain to alter their thinking."
With the explanations finished Watson and Wyka moved on to a hands-on demonstration. EMT Jennifer Harmon volunteered to be the patient, with Training Officer Jason Erlewine, Assistant Chief Brian Newberry and Paramedic Kevin Elliott acted as the emergency responders sent to help her. Watson explained the scenario as Harmon was being strapped to a gurney taken from an ambulance.
"At this point the the patient is calm, but as soon as they start putting on the restraints, she begins fighting," Watson said.
With that, Harmon started thrashing about on the gurney attempting to escape. The three responders immediately swung into action, one pressing a thumb to Harmon's cheek and another taking a restraining hold on her knee, rendering her motionless since movement made the restraining holds painful. With the patient subdued, they were able to move the gurney quickly into the waiting ambulance. Inside Wyka reviewed their performance.
"You find a soft spot that works every time," Wyka said. "You don't over exert. Sometimes you have to do it two, three or four times, but they'll get the point after a while."
He also praised their technique.
"You didn't stop the whole time until you had her secured," he said.
Watson, who is the only personal safety instructor in the entire state, said she hopes more agencies like WEMA across Tennessee will explore these techniques.
"WEMA is the first in the state to study this program," she said, adding she hopes more will follow suit. "They can be certified every year and get continuing medical education units when they are."
Jewell said his primary concern is the safety of his personnel who have no choice but to respond regardless of how dangerous the situation or the injured person.
"In the last six months, we've had some calls that scared us," Jewell said. "With the county growing and the number of calls increasing, we need this."
Staff writer Mary Hinds may be reached at 444-3952, ext. 45 or firstname.lastname@example.org.