�ֲ���ý

By Roxanne Hazleton, MEd, LPC-A                                                                                                                                                 

You never expect it to happen, but the possibility exists that you may have to deal with a medical emergency during a session with a client. Although I had received crisis training throughout my career, I was shocked when I witnessed a client having a medical crisis. 

The signs of a medical emergency may not be immediately obvious during a telehealth session. However, a medical crisis can occur with little to no warning, and even very quietly. Physical signs can include unresponsiveness, with the person slowly leaning to one side. Any lack of speech or lack of movement is a key sign you need to act immediately.

Following Emergency Protocols

This experience, though rare, demonstrates why counselors need to be prepared for a crisis. I emphasize two important emergency protocols to follow with telehealth clients: 

1. Always know the address clients are located at during session in case you need to call emergency services. Verify the location clients are participating from, whether it’s their home or a public setting such as a park, parking lot or workplace. 
2. Have your phone within reach and be prepared to call 911 and explain the situation to a dispatcher. Be ready to provide your client’s address, information on their living situation (if they live alone or with others), if your client has animals, whether they live in a gated community or if there is any obstacle to entry, if the client is taking certain medications, or if the client expressed any suicidal ideations. Also, be prepared to stay on the line with the 911 dispatcher until first responders arrive.
3. Notify the client’s emergency contact about the situation and the location of the person — whether it’s their home, a hospital or somewhere else. 

Seeking Support for Yourself

For me, it was crucial to quickly reach out to my clinical supervisors and clinic executive director for emotional support and guidance, and I am grateful for their wonderful support. Also, I worked with my own therapist to help me process the experience, because there is nothing wrong with the counselor having their own counselor.

Admittedly, I did grapple with questions: What could have gone differently? Was there anything else I could have done so there was a different outcome? Sharing these concerns with your own counselor can help you move through difficult emotions and questions.

How the Crisis Changed My Practices

I do realize the likelihood of my ever experiencing a medical emergency of a client during session again is low; however, this experience has forever changed me and how I practice. 

For example, sometimes I’ll have a telehealth client who wants to do their Zoom session during a lunch break, and they will show up inside their vehicle, parked in some random parking lot. Besides just asking for their location or address, I have now started asking things such as “What kind of car are you in? What are you parked next to?” 

Although rare, medical crises do occur during sessions, and being prepared equips counselors to respond effectively while also strengthening their professional skills. Emergency readiness not only protects clients but also ensures counselors can confidently handle the unexpected.

Note: Opinions expressed and statements made in this blog do not necessarily represent the policies or opinions of �ֲ���ýand its editors.