Uncooperative patient is threatening EMS with pepper spray and not following simple commands. Bystanders state she has been drinking. She is refusing help from EMS. You should?

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When scene safety is in question, the first move is to bring in the proper security to protect everyone involved. An uncooperative patient who is threatening with pepper spray and may be intoxicated poses a clear risk to you, bystanders, and themselves. Requesting law enforcement brings trained personnel to de-escalate the situation, secure the scene, and determine the safest way to proceed with assessment and transport. Forcing transport without consent isn’t appropriate here, especially without a clear legal basis, and it can escalate danger. Leaving the scene or offering only minimal care fails to address the immediate safety risk and potential medical deterioration. In this scenario, the best step is to request law enforcement assistance to stabilize the scene and facilitate safe care and transport if needed.