Sometimes the patient doesn’t want to talk to the EMT. Should the EMT just give up at the first sign of resistance? Sometimes patients just need a little help coming out of their shell. When the patient resists the urge to tell the EMT what is happen, it creates turmoil inside. The best way to defeat the turmoil inside is to show empathy (this is where the EMT says something to the patient to indicate the EMT understands what they are going through). Sometimes it may be necessary to shift the focus onto something else. If the patient is becoming progressively disturbed, maybe shift to a different complaint or a different part of the interview (like their drug allergies). Be aware that the patient may have various defense mechanisms in place when EMT probes too deeply. An example might be asking if a patient takes Viagra. The patient’s ego is going to say, ‘No, I don’t need Viagra….”, when in fact they do and if somebody gives the patient some Nitroglycerin, the patient is going to experience an unpleasant drop in blood pressure. By simply being aware that the patient might not want you to ask a question like that might help the EMT sidestep an unnecessary. Distracting the patient by prematurely moving into a different phase of the examination is sometimes needed to get the interview/examination back on track.

Most patients will be easy to interview. They called 911 and now that the ambulance has arrived they won’t stop talking. The EMT never knows when the interview is going to be tough, which is why he should sort of use the same techniques each time. Start the interview in a normal manner by asking the most open ended question of all time, “why am I here?”. When the patient tells the EMT something, the EMT should write it down and indicate that he is listening. When a question is asked, it may be necessary to explain the question and why it is being asked.

Some patients will be difficult to interview because they are drunk or high. It is not up to the EMT to pass moral judgement on people who are intoxicated. Understanding that the patient is drunk is probably more than enough to get to the point and stop frustrating the potentially belligerent patient.

Most of the patients seen by EMS will be elderly patients. Elderly patients often have visual and auditory deficits. It may be necessary to obtain their glasses and hearing aid before continuing the interview/examination.

Be aware of sexually aggressive patients. A patient who is sexually aggressive could be considering raping the female EMT or manipulating the male EMT, either way is a situation best avoided. When confronted with a sexually aggressive patient, the EMT should have somebody ride in the back with the EMT and the patient. A would-be sexual predator or sexually manipulative person would generally not be bold enough to try something in the presence of an audience.

When speaking to pediatric patients, it is always necessary to have a parent or guardian with the patient at all times. If an EMT must address a pediatric patient directly, every effort must be made to give clear explanations.