Cooling the Flames
De-escalation of Mentally Ill & Aggressive Patients: A Comprehensive Guidebook for Firefighters and EMS
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People suffering from psychiatric or substance abuse disorder can display any one of a number of frightening behaviors. Ellis Amdur and John K. Murphy offer firefighters and EMTs a comprehensive set of strategies to keep themselves and their patients safe, while functioning at the highest level of professionalism. Rather than abstract information, more useful in a consulting room than in the field, Cooling the Flames is tactically based, from start to finish. The first section of this book addresses field safety, including both strategic planning and honing your intuition to pick up early signs of danger. In the second section, the authors offer specific strategies to maintain integrity and calm in crisis situations, including a method of breathing for the purpose of maintaining one's own center in crisis situations. They then discuss interventions with those displaying confusion and obsessive concerns, psychosis, mania and acute disorganization. In one very important section, they discuss interactions with manipulative people, who present a danger to the psychological and physical well being of anyone with whom they come in contact. The authors discuss suicidal patients, not only from the perspective of despondent individuals who attempt to kill themselves, but also offer strategic interventions for those who either threaten to harm themselves, or repetitively do so, requiring regular involvement of EMS, police, hospitals and the mental health system. The authors explain how to immediately recognize different modes of aggression, and then outline how to quickly and effectively implement de-escalation or control tactics best suited to deal with the type of aggression one is facing. In three essential appendices, they present protocols for physical and chemical restraint, current information on positional and compression asphyxiation (authored by Dr. Gary Vilke), and a protocol, specific to fire and EMS, on excited delirium (authored by Lt. Michael Paulus, ret.)
John K Murphy
JOHN K. MURPHY, JD, PA-C, MS, EFO, retired as a deputy fire chief after 32 years of career fire department service, managing all areas of fire department operations and management positions. His past fire and emergency medical experience has been as a paramedic/firefighter for more than 20 years; paramedic program director, chief fire officer, chief of training, emergency operations chief and health and safety officer. Mr. Murphy lectures and writes on issues related to fire law and management. Mr. Murphy was a US Navy Corpsman serving with the US Marines. Mr. Murphy is an attorney with the Murphy Law Group, focusing on employment practices liability, training safety, employment policy and practices, forensic evaluation on fire and EMS operations, internal investigations, and as a subject matter expert in pre-hospital EMS and fire operations, consulting on risk management for private and public entities. He also has experience in family law, contracts, non- profit incorporations, mediation and internal investigations. He is the Vice President of M2 Resource Group, Inc., a consulting company specializing in Fire and EMS legal and operational issues and a Physician's Assistant with a focus in urgent, emergency, occupational and pre-hospital medicine medical care. Mr. Murphy is the author of Legal, Political & Regulatory Environment in EMS, a Prentice Hall educational publication. Mr. Murphy has a Juris Doctor (JD) from Seattle University School of Law; Masters of Science (MS) degree in education and Bachelors of Science (BS) in Paramedicine from Central Washington University and graduated from the University of Utah School Of Medicine, Physicians Assistant Program (MEDEX) and is an Executive Fire Officer Graduate. He is a licensed attorney in Washington and New York, a member of the bar associations in Washington, King County and New York. He is a member of the Association of Fire Service Attorneys; National Society of Executive Fire Officers; International Association of Fire Chief's; U.S. District Court Western District of Washington and legal counsel for the International Society of Fire Service Instructors (ISFSI), and an adjunct instructor for the University of Florida Fire and Emergency Services program.
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