Last summer, a 45-year-old woman threatened to kill a nurse at Stanton Regional Hospital and began shouting and throwing bloody tissues and pads around.

In December, an Inuvik hospital guard was stabbed by an unstable patient who had stopped taking his medication.

Kerry Beauchamp is manager of Physical Services at Stanton Regional Hospital. He's frequently reminded of the dangers of helping people who enter emergency shaken and upset.

"Emotions can become heightened," he said. For instance, a person's relative may have been hurt in a car accident. "The person may lash out in desperation, screaming at us and wanting information desperately."

"It's something that comes with human nature. Our responsibility is to provide structure to respond to it."

Usually, up to three guards are on duty at the hospital. In November, Stanton added a security guard in emergency who makes sure people sign in and out.

Masters Security in Yellowknife has the hospital security contract.

Guards, who don't carry weapons, receive training in non-violent crisis intervention. Other staff receive this training as well.

"Every nurse, for example, is certified as a responder because they are going to be in situations where they need those skills," said Beauchamp.

If someone's emotions seem to be escalating, a team of people respond to it. One or two people will try to "talk the person down."

Others will stay on the perimeter, checking to make sure the situation doesn't escalate further.

"We put a presence around the person," said Beauchamp.

Every situation is different, he added, but problems generally arise when a person is upset, intoxicated or both.

"They might be in a mixed state, not cognitive of how they are behaving."

Usually, the behaviour does not start off violent, but escalates. So catching it early becomes crucial.

"Quite often, you can calm someone down just by acknowledging their state and leading it away from crisis," said Beauchamp.

For instance, staff might point out how the person is behaving and what the consequences of their actions could be.

The hospital uses a "CODE WHITE" system to alert others. Beauchamp said there are "structures in place" to contact RCMP, but asked to keep protocol confidential.

Stanton has a no-tolerance policy for abusive verbal and physical abuse. They can refuse to treat a patient whose medical condition is non-life threatening.

"We're not going to let someone get into a situation where their life is in danger if they need medical attention," said Stanton's director of operations Donna Zaozirny.

"But if they are kicking and screaming and hitting, we can't get near them. We can't put staff at risk."

The hospital tracks the number of potentially dangerous situations, ranging from verbal to threatened physical abuse.

Zaozirny can't remember the last time an incident escalated to physical abuse.

"Someone might smash a door, kick a wall. That does happen ... there's a good potential someone was punched."

But she said these incidents are few and far between.

"In a year, we have about 40 reported incidents," she said. "And we have about 19,000 people who come through emergency."

"But there's always something. People might be upset, and profanities might be flying. Usually, things can be talked down."