G.3.23 Care/Transportation of Psychiatric Patients

PURPOSE

To provide Paramedic services staff with direction for the care and transportation of psychiatric patients.
 

APPLICATION

• Paramedics
• Paramedic Superintendents
   

PROCEDURE

Manitoulin-Sudbury DSB, Paramedics Services personnel will regularly be engaged in the care and transportation of psychiatric patients from the community to health care facilities, and between health care facilities. This patient population is categorized as either voluntary or involuntary, and the directives for interactions are as follows.  

Voluntary admission of psychiatric patients pertains to persons seeking admission to a psychiatric facility/health care facility.

Involuntary admission of psychiatric patients pertains to persons who have had one or more pieces of legislation utilized to restrict their ability to refuse treatment, and transportation to a facility. Persons can be transported against their will, subject to the following provisions of the Mental Health Act:

• Form 1 - the subject of an application for assessment by a physician under subsection 15(1) of the Mental Health Act, or
• Form 2 - the subject of an order for examination signed by a Justice of the Peace under subsection 16(1) of the Mental Health Act, or
• Form 3 - detained in a psychiatric facility under a certificate of involuntary admission, or a Form 4 - Certificate of Renewal, or
• Form 8 - remanded by a judge for admission to a psychiatric facility under subsection 22(1) of the Mental Health Act, or
• Form 9 - Absent Without Leave and is subject of an order for return to a psychiatric facility under subsection 28(1)(b) of the Mental Health Act.

USE OF ESCORTS

Paramedic Services requires that a sending facility arrange a medical escort to assume responsibility for the transportation of all psychiatric patients. Where the transportation is from a scene, the escort needs will be determined by Paramedics, and may include Police Officers, Court Officers, or Custodial Staff.   

RESTRAINTS

Paramedics will not take part in the restraining of any patient unless they are assisting, and following the direction of a Physician, assisting a Police Officer who requires immediate assistance, or where a patient becomes violent and impacts on the immediate safety of the Paramedics. 

Should any Paramedic Services staff engage in restraining a patient, the force deemed acceptable to ensure safety will be the minimal/reasonable force required.

Paramedics engaged in any type of patient restraint shall document the actions on the ePCR and shall complete an Incident report that details the rationale, the person who directed the action, the method and any outcomes.  

Paramedics should reference the Basic Life Support and Patient Care Manual, Section pertaining to the Restraint of Patients Standard, and the Violent, Aggressive or Agitated Patient section for specific guidelines in relation to managing patients.

REFERENCE

Ministry of Health, Emergency Health Services Branch, Basic Life Support Patient Care Standards

Ministry of Health, Emergency Services Branch, Documentation Standards

Ministry of Health, Emergency Services Branch, Basic Life Support Patient Care Standards