Body Language for EMS: Part 2—Assessment

Reading your patients’ body language can help you defuse potentially violent situations

As EMS providers, we sometimes find ourselves just going through the motions of a medical call. Respond, treat, gather information, transport and get back to the station or post. How many of us break out of that mold and voluntarily take additional training because it’s interesting, provides us with an advantage and may help us better understand our patients?

Studies by leading body language experts show when individuals are tested on their ability to read and interpret non-verbal communication, those without prior training do no better than chance (approximately 50%) on the tests.1 Though emerging studies show there are individuals who do seem to have a natural ability for reading others, most people have to study and practice to become—and remain—proficient.

In August 2006, one of the FBI’s most wanted, polygamist Warren Jeffs, was captured after the SUV he was a passenger in was pulled over by a Nevada Highway Patrolman for having improper license plates. According to the patrolman, it was actually Jeffs who tipped him off. Jeffs seemed evasive, would not make eye contact with the patrolman and his visible carotid artery was pumping extremely fast.2 That led the patrolman to dig further and resulted in Jeffs’ arrest. Had this patrolman just gone through the motions and dealt with the vehicle’s driver, he may never have discovered who the passenger of the SUV really was. That’s just one example of how possessing the ability to read and interpret non-verbal communication can be a powerful tool.

Norming vs. A Quick Assessment

Some people just ooze behavioral clues, while others are aware they’re being observed and try to act as normal as possible. For those who aren’t aware just how easy they are to read, or for those who might be a danger to themselves and others, a quick assessment is probably the best way to start. People who are being deceitful and attempting to cover something up take a little more work and require some “norming.”

Norming is a way of trying to determine an individual’s baseline, or how they normally act, to better gauge their responses to specific questions and situations.1 A similar technique is used by polygraph operators when they begin their testing. However, one of the downsides to polygraph testing is that the operator usually doesn’t know the subject being tested, and because the subject knows they are under the microscope, it stands to reason they’re going to act and respond differently than they would if they didn’t know they were being evaluated. If someone close to you (family or friend) is acting a bit odd, you would notice. The reason you’d notice is because you know the person well and you know how they normally act. Considering the relatively short amount of time typically spent with a patient, EMS providers are at a disadvantage when trying to obtain information by evaluating body language. You should start any assessment with some basic, easy questions. A small sample of questions you can use includes, What is your name? How long have you lived here? What do you do for a living? Tell me what you had to eat today.

While speaking with the patient, observe their behavior not only as they reply, but as you’re asking your questions. Watch their face—do they show any expression of emotion or do they have a blank stare? Do they fidget around on the stretcher? You can also “check your math” here by saying something you both know is wrong just to see how they respond. Purposely pronounce their name wrong, repeat the wrong birthday or address back to them, mention that it’s Friday when it’s actually Wednesday. Take into account how they behave when they correct you. The patient shouldn’t have a reason to lie when they answer these questions or statements, so they shouldn’t feel uneasy answering them. Suffice it to say, the manner in which a patient responds to such simple questions or statements can serve as an indicator of how they normally act when comfortable with a question or situation. A baseline has now been established.

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