Paramedics/EMT - Hypnosis Use

[AnthonyM83]

I'm looking to see if there are any medics out there who use hypnosis in the field. I'm an EMT student and starting the clinical rotations, soon.

I'd like to know if there are current emergency responders who have any sort of system set up for using hypnosis. Certain patters you might use or certain points of a call that are good for inserting stuff there. Right now, I'm finding it hard to add in much at all b/c treatment of patient is taking my full attention, so I can't quite experiment with it, yet.

[Merlin]

If you want to discuss hypnosis applications for EMTs, this is a good place, but if you are looking for what other EMTs do, you'd probably be better off finding an EMT list.

[Don]

I received some info from Don Mottin, a well-known hypnosis teacher, that he is teaching a class on emergency hypnosis and how to teach it to people such as EMTs. You can contact him (do a web search) to see if it will be coming to your area or if they will be making videos of the class.

[Merlin]

Omni teaches a course too.

But then, that doesn't answer the question :)

[AnthonyM83]

That at least gives me direction. Thanks.

I've posted on one EMT site so far wondering if anyone uses it or would be interested in its use. The main response was interest with skepticism, but a general unwillingness to even get simple scripts that I described as distractionary to use with children with bone fractures (figuring this way they wouldn't be embarrased at failing & their easier 'subjects').

The one guy who did know about hypnosis said he had studied it for 3 years, said it was very complex, and most people who use it have PhD's in it. I replied point by point, but I don't think it changed anyone's mind overall.

Except for those classes mentioned (Omni & Mottin), I might have to develop stuff on my own once I get in the field (hopefully with help from here), then spread it through other EMTs who witness its ease of use first.

[Terry (existing)]

I thought you guys were taught techniques during your training, since I note how upbeast most EMSs are. A good bedside manner of course, and confidence in eventual outcome are important, but I certainly disagree with you as to experimenting. If it isn't natural, it won't give you the outcome you hope for. Leave the real stuff to those who will have more time with a client than you get, and develop your own outlook to pass on to those in need of a boost. If you are feeling down, don't pass this on the the client. If you are feeling good, share that feeling. That way, you do no harm, and often will make the difference between a successful confrontation and a failure.... You don;t need training for this, just a confident outlook that shines from you at all times when dealing with a sick client....

[AnthonyM83]

I certainly agree that attitude of an EMT is extremely important, as patients look to the professional treating them for their emotional state and level of worry.

I wish to be able to provide more than that, though, such as release from pain from appropriate conditions, such as a fractured femur. Granted I haven't been out in the (EMT) field except as a ride-along, but I suspect the pain control techniques I know require a higher level of focus on me than most patients will have during excruciating pain.

I don't mean to do heavy experimentation, necessarily, but perhaps different patters I could use while I take a blood pressure or set up a splint/immobilization device.

(That's if I read your post correctly...)

[skip]

Anthony,

My personal experience is that the 'hypnosis' message has to a great extent already been accepted.

People say things like, "Im going to give you this medecine ...", instead of 'this shot'. The unconscious message is clear, "Medecine heals", "shots hurt"., so you dont give shots.

You are also already warned about what to say around the patient. Never say, "Oh God, it is sooooo awful ..." or "That is usually fatal.", you always keep everything positive and encouraging.

So those things have gotten thru.

There is a fellow named Elman who taught rapid inductions. you might want to look at some of what he did with an eye towards pain mitigation and control of bleeding.

There is a fellow named Erickson who used conversational techniques, the story of his intervention with his son whose teeth were knocked loose, or another son who needed stiches, is illustrative of how this type of hypnotic technique could be used.

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[Merlin]

Anthony,

Just get good at instant inductions.
Then understand how words influence.

The rest is *easy*

P.S.
Most people think of hypnosis as 30 minutes of relaxation.
Not soething an EMT would have time for.
Also, hypnosis could create legal hassles without an MD 'prescription' specifically for hypnosis.

[Merlin]

It's actually easy to ease pain under those conditions.
I posted how once, but I'm sure it's buried in the archives somewhere.
But like I said, can you *legally* administer something like this for pain?
A 'good sameritan' off the street might get away with it, but what about in your legal position?

I know nurses don't do anything without a Dr. order.
What about EMTs?

[AnthonyM83]

Technically, if it's not in the pre-written protocols or advised by medical control (over the radio), we can't do it.

Since there are many ways to do hypnosis, I was hoping I could find something that could be passed off as "comforting the patient". Telling a child patient that hugging their teddy bear will make their feel better isn't in protocols either, but it'd fall under general bedside manner and reassuring patient.

I think this would be the only way I could officially be allowed to use hypnosis, as part of beside manner and emotional comforting.

I've been told people in pain are in a trance already and extremely suggestible. Can someone corroborate and refute this? I feel I personally would be less suggestible if I were in intense pain b/c that pain would totally take over my reality.

Hypnotist: "Your leg is beginning to feel comfortable now"
Me: "No, it's not!? It's HUUUURTS!!!"

But that might not be true for most people...

[Terry (existing)]

Anthony, we have all given you some good pointers, and I believe if you look closely, you will note that we all agree. You can go so far and no farther, because of your status. Now if you want to practise hypnosis, fine, do it, but if you want to remain an EMS accept that hypnosis as such, and excluding such techniques as can be applied instantly, are not part of your job desciption, and we should not and will not encourage you to continue along this path so long as you are in the position you are.... After thirty years or so, you may well have developed methods of using more techniques into your regular work, but that is in the distant future, and assuming that you continue to study and practise outside you regular work hours. Helping you with techniques without proper knowledge of the how and the why, is not in your interest or ours......

[Merlin]

Well,

Sometimes you can withhold the truth.

Point one: crowd control.
Assume the CF is bypassed already.
Any comments from anyone is a suggestion.
Someone doubts he'll live, just gave him a suggestion to die.
Avoid it.
Enlist someones help to keep the crowd/onlookers away.
The subject's hearing is magnefied. Get the crowd *far* away!

You are the authority now.
What you say is the suggestion(s) accepted.

Point two:
*Lie*!!!!!
I cannot over emphasize this!

Comments like:
Oh, this isn't so bad.
You'll be better in no time.
Maybe we can have a beer next week and talk about this xxx.

See, you're hypnotically programming them to quickly heal :)

Avoid words such as pain, shot, hurt, mess, anything which might be taken negatively.

'I'm going to be working over here. You can feel where I'm working. But nothing I do is going to bother or disturb you in any way. You'll just know I'm fixing you up.'
Is good for pain.

Maybe, if you can get away with this. I don't know:
" I'm going to use this new anesthetic over here. You might feel a little tingle, but otherwise you'll just FEEL GOOD NOW" (notice the emphasis of words).

Then, spray something in the air so that it is heard Sssssss!

Above all, AVOID THE NEGATIVE WORDS!

[AnthonyM83]

Thanks everyone for all the suggestions. I'll integrate as much as I can when I go out in the field.

BTW, Terry, while I'm certainly no expert with hypnosis, but I'm not just a random EMT off the web thinking it'd be cool to hypnotize his patients. I've been studying it for 18mo, have certification from 40hr class, weekend workshops, Ericksonian class, number of mini-seminars/workshops from the well-knowns, weekly practice group, and a 12hrs weekly hypnosis internship since June with a clinical psychologist and experienced lay hypnotherapist, plus the side reading.

Definitely still new at this and still young, but working to better understand that how and why.

Again, thanks to everyone. I take all your replies seriously and with weight.

[kosmic]

if you try merlin's suggestions, could you tell us the results? i'd greatly appreciate that!

[AnthonyM83]

I incorporated a few suggestions today . One of my jobs is a teaching assistant for elementary schools. A pretty tough 1st grader was hit on the side of the head near the eye pretty hard and was crying (this isn't the kind of kid who cries easily).

I told him to keep his hand on his eye (which he was already instinctively doing) to start making the pain go away (didn't use the word pain after this). I asked him what his favorite kind of popsicle was. I told him side of his eye was turning into a orange popsicle. A cold icy popsicle, so cold and numb. As soon as I started describing feeling the icy particles making up the side of his face, his crying turned to semi-sobs (no crying) within 30 seconds...as he concentrated on that feeling. Then gave some accelerated healing suggestions and linked those to the icepack we brought him.


I'm sure part of it was just maintaining his concentration on something other than the pain, something that was so weird (his teacher telling him his eye was a popsicle), but also partly imagining the icy numbness.

[kosmic]

thanks for sharing the field experience. have you tried using merlin's suggestions yet? (i mean using her examples word for word)

[AnthonyM83]

Haven't had the chance since I haven't had to actually "work" on anyone, yet. I'm still in school and while ambulance/ER ride-alongs start soon, I'll probably be totally focused on my ABCs at first.

Some of the things I can only use with young kids (like placebo anesthetic), b/c we're supposed to truthfully tell the patient each thing we're doing and why (so they could theoretically give implied informed consent), but with younger children I wouldn't have a problem fibbing on the treatment b/c they couldn't refuse treatment anyway.

[Merlin]

>we're supposed to truthfully tell the patient each thing we're doing and why

How unfortunate.
Laws setting us up for failure <sigh>

[AnthonyM83]

>we're supposed to truthfully tell the patient each thing we're doing and why

How unfortunate.
Laws setting us up for failure <sigh>
Well, we just had our segment in Pediatric Emergencies in class, today. One of the main themes was never to lie to the children. Our instructor repeated this over and over, as did the narrator (with great emphasis) in our training videos.

"Always warn a child when something you do may hurt, such as inserting an IV. Be truthful with children, as their cooperation is essential. If a child looses trust in your, you will loose that cooperation."

Will me saying that the IV going into the arm is going to feel comfortable or just a pressure going to have an effect?

I remember going to the doctor as a kid and everyone (nurse, doctor, mom) telling me it wasn't going to hurt. That I wouldn't even notice anything happening and it'd feel fine and be totally over with really quickly. I was a very trusting kid, especially to authority figures, but I distinctly remember being very angry that I was lied to, because the shot hurt me and kept hurting me for awhile.

[skip]

They are right dont lie, but you already knew the answer to that.

But you dont have to say "hurt" either.

"Now Im going to put this IV, for medication, in your arm. You may feel something, for just an instant, but it wont last long, and it will make you feel better, you do like feeling better dont you?" comes to mind.

Notice I said "medication" and not "medicine". Most every kid has been given "medicine" and they know it "tastes bad", so medicine has a poor connotation, and they know that dont like 'medicine'.

JAT

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[Don]

When I was very young, I became very sick. The doctor examined me. I told him I'd do anything, take any drug, just don't give me a shot!

He said, "O.K., I'm not going to give you a shot. I'm going to give you an injection. It may feel a bit like a shot, but it's really an injection. Is that okay?"

"Yes," I replied.

BAM!!!!

[AnthonyM83]

Thanks guys.

I also forgot to mention, I've started doing the ER visits and ambulance ride-alongs (spread out over a couple months). I already started getting into the habit of adding "so you can start feeling better" after most actions (repositioning a patient, giving them water, giving them a blanket, administering oxygen).

[Merlin]

The idea would be to not use such words as 'hurt'.

More like:
"I'm going to be working here on your arm.
You'll notice i'm touching you. you can feel it.
But, nothing I do is going to bother or disturb you."

Notice the suggestions :)

>I remember going to the doctor as a kid and everyone (nurse, doctor, mom) telling me it wasn't going to hurt.

As soon as anyone uses the word [hurt], they set expectation.

Notice the phrasing, going to hurt.

Also, we are assuming CF bypass in your patients and you as an authority giving suggestions.
It may take a little time before you become proficient at suggestion. Get practice where/when possible.

[Merlin]

>"so you can start feeling better"

Good!

[AnthonyM83]

I wanted to share that I have wrapped up my old job and am now working as an EMT in a very busy part of the California. I'm brand new to the job and haven't worked out in advance different patters (I get easily flustered when speaking, so that helps me).

But I recently was able to greatly reduce the anxiety of a woman with a deep upper leg laceration and bruising throughout. A heavy gate had fallen on her. When we found her, she was crying, deeply breathing, and grunting in pain. When she was transferred from the fire department medics to us, I wasn't quite sure what kind of patter to us (BTW, her leg was already wrapped and splinted). It's very important that it does not seem like hypnosis or anything strange, as that would likely result in me immediately losing my job.

I was able to suggest to her that "The best way I've found to reduce patient's pain (only used "pain" once) is to concentrate on a pattern, it can be anything...somethign you see or something you hear."

She nodded immediately and closed her eyes. I took that as her wanting something more audible, so I told her, "You can concentrate on the sound of the air conditioning flowing out of the vents. As long as you hear them, it can help you relax as you focus on them."

Then when we arrived at the hospital, I told her, "We're going to roll you out to the emergency room now and there's going to be a number of bumps and people talking. I want you to keep concentrating on a pattern...the sound of the gurney wheels turning and bumping and people talking are just a sign that they're working on helping you and treatment is getting closer. The worst is over and from now it's recovery time, okay?"

She gave me a sweet smile and a thank you. I don't know how much it eased her pain, but it definitely IMMEDIATELY lowered her anxiety level (or so it seemed). She stopped crying and breathing rapidly. She had her eyes closed and breathing deeply the entire ambulance ride.

I was hesitant to give specific suggestions on the leg becoming comfortable as that's crossing the line a bit more and wasn't sure how to best put it subtely, so that in case it didn't work, she didn't get weirded out (once patient complaint or one patient asking the ER doctor what the EMT was trying to do that leads to a call to my company could have serious consequences).


Anyway, I know there's not that much documented information on hypnosis use in the field, so thought I'd continue posting in this thread as much as I can. At times it's hard to think about hypnosis, because I'm still learning basic patient care (since I'm new).

[Stoic]

Once in a while I do some donor phlebotomy and use very casual suggestions and pattern interrupts to make it less painful and stop people from passing out.
Example: Instead of telling them to "relax their hand" after they squeeze the ball, I tell them something like this "relax <pause> alllll overrr, now, So... where you from?" As soon as they start to answer, I stick, then follow with a comment about the place. Sometimes I do the "hand shake" when putting on the blood pressure cuff and when I see the opening I start pumping relaxogestions. Sometimes I try to anchor relaxing, to me anchoring the vein. Getting all technical works really well with the curious ones. I very rarely have people pass out on me. Kinda miss those days, all I do now is play around with tubes. Sadly, you can’t hypnotize test tubes.

[Connie]

I don't have specific details of what was done, but I did see emergency pain relief hypnosis in action. It's valuable stuff!! I was at a stage show, and some men/volunteers on stage were dancing. Suddenly, this one big guy goes down. We didn't know what happened. He was lying on the stage in pain and couldn't move or get up. (Found out later he had dislocated his kneecap.) The hypnotist checked on the guy, and immediately ended the performance while he tended to "the doctor side of what I do." For the next 20 minutes or so while the paramedics came and tended to the man, cut off his pants, immobilized the leg, put him on a stretcher, etc., the hypnotist crouched there doing something to the man's hand. He was holding it up and it looked like putting pressure on it, while talking to the guy. I caught a few glimpses of the hypnotist's face...he was serious and concerned and utterly focused on helping the man through this. Nobody wants to see anybody hurt (especially during a performance), but I have to say my respect for the hypnotist increased tenfold with the manner in which he handled the situation.

[tdiamond]

I have to say this site is amazing!

To be able to read all this knowledge and participate in these discussions is an invaluable learning experience and you all are fabulous.

Merlin, I especially love your posts and enjoy the nuances of NLP woven all through them.

I feel blessed to be a part of this process, in this lifetime and creating my reality with it.

Anthony, go get em! You are going to be fabulous and if I ever need an EMT I will be happy to see you.

Tanja

[Merlin]

... "The best way I've found to reduce patient's pain (only used "pain" once) ...

Try:
The best way i've found to begin feeling better...

That way you can avoid the p word :)

[AnthonyM83]

Hope you guys don't mind me using this thread as a sort of blog.

But I was once again able to use hypnosis to calm a patient. One was having an anxiety attack, he was feeling like throwing up and breathing extremely erratically. Since, I had time during the transport in the back of the ambulance I was able to do an actual progressive relaxation and anchor to his breathing for relaxation. His condition got better immediately.

For another patient hyperventilating over an argument to the point of her hands involuntarily contracting (carpal spasms). I tried calming her down, but she was too freaked out by what was happening to her hands to break the cycle...it just kept exacerbating her condition. Realized the only way to remove her from the anxiety of what was going on was to have her go in her head...couldn't do a formal induction with a group of firefighters staring at me, so did a quick lead into remembering a fun vacation. Her worried look turned into a smile, she actually chuckled and moved her arms (they were paralyzed from the anxiety earlier), and she started to come out of the anx. attack.

I have still to use it for more advanced situations and traumas, though. It works great for psychological emergencies, though.

[Connie]

DO keep sharing, Anthony! It's fascinating! :) Good job!

[Don]

Not only that, but keep your own records of such experiences. I think it would make a great paper that could be submitted to a paramedic/emt journal. It could also eventually provide you with a new career, speaking to paramedics all over and even training them.