Ed, a 49 year-old male who was attending a party, was found by friends lying on
the pavement with evidence of vomit around his face.

Ed, a 49 year-old male who was attending a party, was found by friends lying on
the pavement with evidence of vomit around his face. After several minutes of
unsuccessful attempts to elicit a response from Ed, his friends called an
ambulance. The friends tell ambulance communications the last time anyone saw
Ed alert was 2 – 5 minutes ago when he went outside for a smoke.
You and your colleague Sarah are the paramedics called to attend. On your arrival
you find Ed looks vaguely familiar. He is now slumped but supported in a sitting
position by his friend Joe. He is holding his head and slurring his words, mumbling
“I’m fine, I’m fine, I don’t want any help”. With encouragement from his friend he
agrees to talk with you. You note he smells strongly of alcohol. His words are
slurred. There is vomitus around his mouth and you note a contusion developing
over the right side of his forehead. Ed is unable to recall how he hurt his head and
is increasingly agitated by your questioning and attempts at assessment.
You are unable to obtain any health history from Ed and his partner has not yet
been able to be contacted. His friends are also unable to assist although someone
thinks he has high blood pressure and is “stressed out heaps” but the information
is not confirmed. They report Ed has had “quite a few” drinks tonight, but cannot
specify how many. Neither can they specify if any drugs have been used. He
continues to slur his words and repeatedly mumbles he does not want to go to
hospital. Attempts to take vital signs make Ed physically combative. He refuses
to comply with your requests to lay still and immobilize his spine. He appears pale
and sweaty, and looks as though he is about to vomit again.
You and Sarah decide to transfer him to the emergency department for further
investigation. He continues to refuse, becoming combative and verbally abusive.
Ed shouts, lashes out, stumbles and is unable to maintain his balance. He is
mumbling and swearing, saying that he didn’t call the ambulance and he doesn’t
want to be touched. Sarah decides to call for police assistance to help restrain him.
Shortly after their arrival and further attempts to verbally calm Ed, he is physically
restrained.

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