PULSE Magazine | June/July 2019 Issue

De-escalation Techniques

 A person clenching his or her fists or tighten- ing and untightening their jaw.  A sudden change in body language or tone used during a conversation.  The person starts pacing or fidgeting.  A change in type of eye contact.  The “Rooster Stance” chest protruding out more and arms more away from the body.  Disruptive behaviors such as yelling, bullying, actively defying or refusing to comply with rules.

We must continually improve our ability to devel- op and maintain situational awareness under stress. As first responders it is imperative to have a thorough understanding of situational awareness what it is, how challenging it can be to develop, and how easy it can be to lose. The term " situational awareness " refers to a per- son's ability to be aware of what's going on around them. I call it being " mentally engaged " though you may hear the oft cited military term " keep your head on a swivel " which means to always be looking around you, being aware of your surroundings. we need to remain vigilant and observant at every phase of these calls and assess every changing situation. Crew members need to watch everyone around them at all times. These seemingly innocuous calls might be setups for an attack on first responders. When you arrive, and while interacting with the public , responders need to watch the hands and mannerisms of each person. Weapons can come from anywhere and are in all shapes and sizes; they don’t have to be conventional things you would think of such as knives and guns. The weapons can be anything. Assessing scene safety is paramount during every call for service that a first responder answers, and it is critical to remember that every call is unique. “never turn your back” and “try to position your- self in a room where you have easy access to the door. Arguably the most important part of situational awareness is how to recognize potentially violent patients and de-escalate situations and interac- tions. Risk factors in violent patients include a history of aggression, psychiatric disorders, substance abuse, feeling powerless, and the perception that violence is tolerated. A person during a crisis and in the heat of the moment can- not always communicate their thoughts, feelings or emotions clearly. They may find it difficult to understand what others are saying. Therefore, it is important to empathize with the person’s feelings, stay calm and try to de-escalate the situation.” Anticipating potential conflict is important for pre- paredness, and there are many verbal and non- verbal cues to be mindful of as situations unfold. For recognition, here are some signs of conflict escalation:

De-escalation techniques that include the follow- ing outwardly expressed traits and emotions by first responders:

• Open, honest, genuine;

• Self-aware, confident but not arrogant; calm appearance to convey control of situation; • Non-judgmental; non-threatening, non- authoritarian manner; • Awareness of body language like eye contact, facial cues, posture to ensure it expresses concern; • Actively listen to understand what the aggressor is saying;

• Use soft tone of voice that is calm and gentle;

• Use short sentences and simple vocabulary; provide aggressor time to respond before continu- ing;

 Repeat messages when talking, setting limits, offering choices, or proposing alternatives.

 People respond positively to their own name and can make the dialogue more personal.  Listening to the persons concerns. Acknowledge there feelings without passing judg- ment.

 Empathy needs to be shown during conflict situations.

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