Medical Evaluation of Person in Police Custody

Section 1 - ADMINISTRATIVE POLICIES

1.08 MEDICAL EVALUATION OF PERSONS IN POLICE CUSTODY

There are times when EMS is called to evaluate patients that have been arrested or in police custody pending investigation. These patients may be under the influence of alcohol, and/or drugs; and may have attempted to flee or resist arrest. In some cases, the patient may have been incapacitated with pepper spray, mace or a Taser. The patient may complain of chest pain, difficulty breathing, or injuries associated with arrest. The patient’s sensorium may range from altered to agitated status and may demonstrate hostile or violent behavior. Approach the patient in a non-threatening manner, using extreme caution.

TASER-RELATED INJURIES

• Initial Medical Care (2.01). Consider OXYGEN and cardiac monitor for potential cardiac abnormalities. Perform a 3-lead evaluation on all patients. Perform a 12-Lead evaluation if the patient is greater than 35 years of age.
• Determine from the patient:
  • Date of last Tetanus
  • Any cardiac history
  • Any ingestion of mind altering stimulants, (PCP, Cocaine, Ecstasy, etc…)
  • Determine if the patient has an “Emergency Medical Condition” as defined in the Incapacitated Patient Act, FS 401.445.

STABLE (PROBE REMOVAL ONLY)

Identify the location of the probe on the patient’s body. Generally speaking, if the only medical conditions are the probes, it is safe to remove them on scene using BSI precautions [assuming the probes are not imbedded in the head, face (except cheek), neck (particularly in the larynx), or groin]. This requires the wound to be treated with an antibacterial wipe and bandaged. The removed probes must be treated as a biohazard if they have penetrated skin and safely put in to a sharps container or returned to law enforcement as evidence. *(probes may be placed in a small sharps container). There may be some redness from a light burn. The probes are straightened fish hooks. They can only penetrate to a maximum of ¼ inch depth. In the event you are unable to remove the probes, transport the patient with the probes.

Consult the local law enforcement agency on the disposal of the probes.

UNSTABLE:

• Unresponsive to verbal and/or painful stimuli. Consider etiology and refer to the appropriate practice parameter. Consider defibrillation or pharmaceutical intervention.
• Chest pain/discomfort with SVT, PSVT, V-Tach or A-fib with a rapid ventricular response, refer to the appropriate practice parameter and consider synchronized cardioversion or pharmaceutical intervention.
• Seizure activity without a lucid interval. Refer to SEIZURE PARAMETER (5.12)
• Agitated – Consider “excited delirium”. Refer to PSYCHOLOGICAL/BEHAVIORAL EMERGENCIES PARAMETER (5.11)

PEPPER SPRAY/MACE RELATED INJURIES: EYES: Refer to OPTHALMIC INJURIES PARAMETER (6.09)

RESPIRATORY: Refer to ALLERGIC REACTION/ANAPHYLACTIC SHOCK PARAMETER (5.02) OR ACUTE ASTHMA PARAMETER (3.01)

TRANSPORT DESTINATION: The patient shall be transported to the nearest emergency department* if the following conditions exist:

• Patient is presenting with an emergency medical condition.
• If we strongly suspect the patient has a past medical history of seizures, drug abuse, respiratory, cardiac, psychological, or any other condition requiring clearance from a physician.
• If the patient is uncooperative or violent, physically restrain as necessary with the assistance of law enforcement. Do not restrain the patient in a prone position. Document use, type, time applied, and reasons for application. Document vital signs, distal circulation, sensory, and motor assessments every 5 minutes.

If patient requires transport, Law Enforcement must accompany patient to hospital.

NOTE: If the patient is uncooperative, probes may be left on the patient during transport.