General Approach to All Patients

Police Custody/Patient Care Standards

When called to a scene to assess a person in police custody perform all assessments and treatment consistent with the standards set for the typical, non-detained patient. EMS personnel are not equipped to perform formal medical clearance for patients in police custody prior to jail transport.

  • After assessing the patient, and treating any obvious conditions, transport to the ED should be offered in a manner consistent with the OCEMS General Guidelines
  • If the detained patient refuses transport, execute a standard refusal process as detailed in protocol
  • Advise the Law Enforcement Officer (LEO) of the patient’s decision, and if all criteria are met, release the patient to the LEO
  • If the patient does not meet refusal criteria, advise the LEO that transport is indicated and coordinate a safe transport of the detained patient in accordance with agency SOPs
  • If the LEO requests EMS transport in a scenario where the patient has refused, comply with the LEO’s request and transport the patient to the nearest appropriate ED
  • In scenarios where a LEO is unwilling to allow transport of a detained patient after EMS personnel have determined transport is indicated (i.e. requested transport, obvious medical necessity or not a candidate for refusal) adhere to the following:
    • Assure that the LEO understands transport is indicated and that medical clearance prior to incarceration is not a process performed by EMS
    • Contact Medical Control for further input and assistance as needed
    • If unable to resolve the issue, defer to the officer’s legal authority to retain custody of the patient
    • Document the interaction well, including the law enforcement agency and officer involved

Taser

For patients who have been controlled by law enforcement using a Taser device; also refer to any protocol that applies to underlying conditions (e.g. behavioral emergencies, cocaine/ sympathomimetic toxicity, etc).

Basic Life Support

  • Confirm scene safety with law enforcement
  • Turn patient supine if found in a prone position
  • Secure the Taser prongs in place if not removed by law enforcement
    • Do not remove the prongs if lodged in the patient and left in place by law enforcement unless there is interference with important patient care measures

Advanced Life Support

  • If the patient requires Chemical or Physical restraints perform Full ALS Assessment and Treatment
  • For patients with severe agitation resulting in interference with patient care or patient/ crew safety, or for patients who continue to struggle against physical restraints refer to the Behavioral Emergencies protocol
  • Transport patient supine or lateral recumbent position only
    • Patient transport in the prone position is contraindicated

DUI Blood Draw

In accordance with Florida Statute 316.1933, law enforcement officers are authorized to use reasonable force if necessary to obtain a DUI blood test from a driver involved in a motor vehicle collision resulting in death or serious bodily injury. Paramedics are authorized to act on a LEO’s request for a blood draw, regardless of patient consent, provided there is no delay in patient care and/or transport.

When asked to draw blood for this purpose, use the DUI blood kit provided by the officer. These scenarios are considered patient encounters, and all EMS documentation requirements and protocols are to be observed.