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O.K. this might be completely useless to anyone who has not been in this sort of situation before. If you have not you may not understand the need for improvement in health care safety.
I work at a Mental health Institute that has both minimum security and medium security units.Our medium security
is really the Max security available for female Pts because there is not a max unit anywhere in the state for females. We are the highest security they will ever see. For men the state has made a max security unit but they can only take a certain amount of Pts and we get the rest whether they belong on Max or not.
Now when Pts become violent we are forced to give them an injection to calm them so that they will not hurt themselves or others. To do that we have to restrain them. If they fight us when we restrain them that puts us ( the staff) and the Pts themselves at risk for injury. Especially if they become violent without warning. We always try to get them to calm down enough to take the shot willingly but often they will just become more aggitated and attack us no matter what we say or do.
Now my idea is this. ( I want you to keep in mind that this is only an idea and it would take alot of work to find out how practical it would be) I would equip all the hospitals where they had violent Pts with small Co2 powered pistols that were capable of launching a syringe up to 30 feet. That way you would not have to be as close to the Pts to give them their injection.
Now I know this sounds like a drastic step to take but you have to remember that you dont always have enough staff to controll a violent pt. and that it is easy for someone to get very seriously hurt even if you have all the staff you could want. I am sure you all will be able to give me some Ideas about how to ensure that shooting a Pt with a syringe does no lasting damage. I want it to be safe for the Pts but also safe for staff who take care of them. If you are still not sold on the need for something as drastic as this or if you dont think it can be done safely and it is too risky I only ask that you stop to think about what would happen if you were alone in a room with someone and they attacked you with the intention of killing you for some real or imagined reason and think to yourself at that point in time when they are coming after me and I have no defense except my own physical strength am I going to think the syringe gun is too risky then or am I going to be yelling for someone to get it before my goose is cooked.
Just an idea
Genetically Hilarious Goats
https://www.youtube...watch?v=RGz97dxGHV8
[bs0u0155, Oct 23 2014]
I would try this on Pt's.
https://www.youtube...watch?v=3t1XPYVbsSo
[pashute, Oct 23 2014]
[link]
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What sedatives do you see this used with? How quick do you expect the sedation to take effect? For a few seconds/minutes your patient would be annoyed and armed with a contaminated syringe. |
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Pt = Patient
Most mental institutes do not regularly house convicts. |
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Chloroform spaycan? It works in the movies... |
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No seriously, I'm all for the idea, but you'd need something very fast acting, and safe for the patient (you don't want to be swapping cartriges about, looking for the correct dose). I don't know enough about biochemistry, but I imagine there would be a fast acting paralising agent available to suit this. Maybe it could be used for emergencies only, and would simply allow the doctor/nurse to safely close the range to administer the longer term manual injection |
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//but I imagine there would be a fast acting paralising agent available//
How about a taser [Custardguts]? |
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so this is just a tranquilliser dart for humans? |
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reading your idea reminded me of two movies - 'Terminator I' and 'Total Recall' |
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bunbunbunbun, i'm hearin ya, Bane. |
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maybe an upgraded tranquiliser gun, but with an average dose, so no personal doses have to be measured, and loaded, fired and stuff, just an average dose, and a couple of spare half doses, in case they happen to be Mc-upsized. |
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It is true that if the dosage was wrong you could end up with an irratated ( But not fully sedated) Pt on your hands. This of course would be a highly dangerous situation to put other Pts and the staff themselves in. The only thing you have to remember is that when you are at the point where you would use this type of device things have already become exceedingly dangerous for all involved. I dont know how many of you will know what I am talking about but there are new types of syringes that we use in healthcare. They are designed to make the posibility of an accidental needle stick much more remote. |
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That sort of thing can happen when you are giving the shot to violent Pts( or convicts for that matter) and is especially dangerous when you have already given the injection because if you get stuck with the needle you are at risk of getting any of the blood borne diseases that Pt could potentially have.
Much of the time we do not have alot of information about the history of a Pt before they arrive at our facility. Therefor we do not know if they have a history of aggression towards others or of harming themselves. We also are unaware of any disease they might be carriers of.
One particular type of syringe that caught my attention for this idea has a special feature. When you give the injection the the needle is out but as soon as the plunger is depressed all the way the needle snaps back into the body of the syringe making it impossible to accidentaly stick yourself with.
I think if such a feature could be employed with this it would make it safer for all involved if the dosage was incorrect and the pt had momentary controll of the syringe itself. Even if they attacked someone with it they would not be able to stab them with it. They would have what amounted to a small stick of dull plastic. The body of the syringe would have to be made out of tough material so that they could not break it to get at the needle. If you could design it that way I think it could be useful. |
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As for it being hard to get the dosage correct you could have a number of different syringes in the med room that were prepared for different body sizes. Then if a particular pt was violent ( and we usually know that they will likely become violent because many people show signs of agitation for at least a short period of time before actually attacking someone) you could get the syringe that corresponded with their body size. For example if they weigh 245Lb you would grab the one nearest to their weight or the one that was directly above their weight. There would most likely only be about ten pounds difference in the estimating so for the 245Lb Pt you would get the syringe from the 250Lb range and use that. It might be a little more than needed but not enough to cause any damage and it would be better in a situation that could very literally become Life and Death to be safe rather than sorry. |
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Allright I seem to have got the cart a considerable distance in front of the horse. To answer the question about what medication I see used for this the answer is simple. No idea. I dont know what sort would work fast enough to make this practical. I only believe that there must be a form of medication that would do it effectively. The only thing I can say is that in some situations that I come accross quite often you could use the same drugs you would use if the Pt was aggressive and violent but allowed you to give him the shot willingly. |
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Many times we have already had a Pt in seclusion when they begin hurtingg themselves. Either on purpose or in an attempt to get out. If you used this product with your average meds( like adivan or haldol) you could administer the shot from outside the room and not compromise safety of the staff. All you would have to do is wait for it to take effect. Even if the Pt continues to be voilent their movements will only make the meds take effect faster. If you designed it right you would not even have the worry of the Pt doing something Inadvisable with the needle while you waited for the meds to kick in. |
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I am also interested in the upgraded tranquilizer gun idea. Not having individual doses would save time and resources.
I am also partial to the idea of a short term but very fast acting agent that would let the RN get close enough to give a carefully measured dose of a longer term sedative.
Anyway I am sure there are more holes in this idea than I could imagine but I am hoping that you guys will see them for me. I will call it quits for now because this is starting to feel of Tolstoy length. |
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By the By what does " Mc-Upsized" mean?? |
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Short of reading your seccond book Bane, I have only one problem with the idea. If the said product could launch 30 ft with accuracy, at 3 ft it seems it would be quite dangerous. |
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Pt is an Abbreviation for the word Patient. We use a type of short hand so that words we use alot in documentation can be shortened to make us more efficient. |
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Another thing too chef, If the violent Pt is three feet away from you it is already too late for this product to be effective. If they are that close they are close enough to hit you so by that point you would want to be getting controll of their arms and go from there. |
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I was thinking about this one. Many self inject syringes retract the needle after injecting. A dart as proposed should do the same. |
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I am not sure how dart guns achieve their injection. If the plunger accounted for most of the weight of the dart it might continue to travel forward under its own momentum after the needle had lodged and the dart as a whole come to rest. But that seems an iffy way to guarantee delivery of the drug. |
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Hmmm. An autoinjecting projectile, with a retracting needle, delivering
a fast-acting incapacitant. |
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As a launcher, a CO2 propelled airgun, similar to a paintball gun,
would be easy to make. It could be constructed of plastic. |
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The 17mm calibre would give adequate scope for engineering the
projectile. An epi-pen has an ellipsoid cross section and is 18mm
across the smaller dimension. |
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The most difficult aspect of this is the pharmacological one -
selecting a fast-acting but safe product that is effective by
intramuscular injection. |
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If such a device were practical, it is likely it would already be in use by
law enforcement. |
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I'm sure animal tranqs would have a suitable effect.
When used on animals, they take some time (a few
minutes, maybe) to take effect. But this might be
good enough, if the patient is not in a situation
where she can immediately harm anyone (or herself). |
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hmm.... CO2 pneumatic propellant and action, selective fire, each round carrying enough med for 50lbs of nutcase. And a bubble machine to get their attention. |
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The problem has always been to get a fast enough knockdown
without compromising the airway. A slow-acting formulation might
not be quick enough to prevent the consequence the use of the dart is
trying to avoid. |
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A tazer is a fast-acting incapacitant. Harmless too, if you
believe the Man. |
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//Use a rag soaked in chloraform to knock them out
like in the movies. I`m not serious. But it`s so funny,
I had to say it.// |
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The problem with drugs is that they have to diffuse in to the blood from some random intramuscular site. Nothing is going to have the knockdown of a taser. |
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Although the Russians were impressive with their fentanyl gas. Faster than a Chechen could pull the trigger on a grenade vest. I wonder how fast 10cc of fentanyl IM would get you peaceable? I bet 30 seconds or less. Plus a specific antidote if there were airway issues, again like the Russians. |
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I would definitely pick 10 cc of fentanyl over a taser for myself. Or the fentanyl before the taser, please. |
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//Although the Russians were impressive with their fentanyl gas. Faster than a Chechen could pull the trigger on a grenade vest// |
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The way I understand it, a) they had been breathing the aerosol mix for some time before they realised it and b) inhalation is a far quicker way of absorbing the chemical than say intramuscular injection, which is all you can hope for with a dart or hurriedly jabbed needle. Not much help on a rampaging mental patient or thug on PcP. |
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You'd also have to supply the gun along with a couple autoinjectors of Naloxone or similar, to try and reverse the effects of the massive overdose you've just given the "PT". This is where the Russians got it wrong (or did they...). |
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Ultimately, I think you'd struggle to find anything that rivals the rapidity of a tazer. Maybe make one with multi-shot, variable power settnigs to releive some of the reliability issues and there you go. |
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Don't you have someone you pay to do that for you? |
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I'd guess his tongue was firmly in his cheek, but he probably pays someone to do that as well. |
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Chloroform or ether actually take some time to take effect. The movie cliche of subduing someone with chloroform is pretty far fetched. It would be both more effective, and far more practical, do do same with a choke hold, than it would to try to hold a smelly rag against someone's face for several minutes. A good choke can have your lights out in about 5 seconds
(which is still a *really long time when that person is angry about it, especially with all sorts of sharp edged furniture and hard flooring materials about). |
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How about some form of pre implanted deep brain
stimulation... only in the motor cortex, one prod of the
remote control and they hit the deck like those genetically
hilarious goats. |
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Sounds like a good non lethal weapon if one like this could
be developed. (Although it seems most people here agree
that such a thing cannot work) |
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