ch 23 Flashcards
What is a behavioral crisis
Any reaction to events that interferes with activities of daily living or is deemed unacceptable by others
What is a psychiatric emergency
A situation where a person’s abnormal behavior threatens themselves or others
What are some possible causes of altered behavior
Medical conditions trauma substance use psychiatric disorders
What is the primary goal when responding to a behavioral health emergency
Ensure scene safety and provide compassionate patient care
What should you always consider first in a behavioral emergency
Possible medical causes of altered behavior
What are signs of a potential violent patient
Clenched fists tense posture pacing shouting threats
What is the best position for transporting an agitated patient
Supine or semi-Fowler’s with restraints only if necessary
What is the definition of psychosis
A state of delusion where the person is out of touch with reality
What are common symptoms of schizophrenia
Delusions hallucinations lack of emotion disorganized speech
What is important to remember when dealing with psychotic patients
Don’t argue with delusions and avoid sudden movements
What is excited delirium
A condition involving extreme agitation aggression increased strength and often sudden death
How should excited delirium be managed
Ensure safety call for advanced support use calming techniques and avoid sudden restraints
What is a key danger with physical restraint of behavioral patients
Positional asphyxia especially in prone position
What should always be documented with restraint use
Reason for restraint type used who authorized it and patient monitoring
What is the EMS role in a suicide call
Protect yourself provide emotional support and transport for psychiatric evaluation
What are warning signs of suicide risk
Hopelessness giving away belongings withdrawal history of attempts
When should law enforcement be involved in a behavioral health call
When there is a threat to the safety of patient or others
How should you communicate with a behavioral health patient
Calmly clearly respectfully and with open body language
What is the first step when arriving at the scene of a behavioral emergency
Ensure scene safety for yourself and your team
What is a psychiatric disorder
An illness with psychological or behavioral symptoms that impair functioning
What is posttraumatic stress disorder (PTSD)
A mental condition triggered by a traumatic event causing flashbacks anxiety and emotional numbness
Why is it important to consider medical causes in behavioral patients
Medical conditions like hypoglycemia head injury or hypoxia can mimic psychiatric symptoms
What should you avoid when interacting with a disturbed patient
Sudden movements loud speech or judgmental tone
What is schizophrenia
A chronic brain disorder causing delusions hallucinations disorganized speech and flat affect
How might a person with schizophrenia present
Speaking to themselves seeing things not present disorganized behavior flat or inappropriate emotions
What is bipolar disorder
A mental illness marked by extreme mood swings from mania to depression
What are signs of a manic episode in bipolar disorder
Increased energy reduced need for sleep rapid speech risky behavior inflated self-esteem
What are signs of a depressive episode in bipolar disorder
Sadness hopelessness fatigue sleep disturbance suicidal thoughts
What is major depressive disorder
A mood disorder causing persistent sadness loss of interest and impaired functioning
How might depression present in a patient
Tearfulness lack of energy withdrawal poor hygiene suicidal ideation
What is generalized anxiety disorder (GAD)
Chronic excessive worry about various aspects of life with physical symptoms
How might anxiety present
Restlessness muscle tension difficulty concentrating rapid breathing or heart rate
What is panic disorder
Repeated panic attacks involving sudden intense fear and physical symptoms
What are common symptoms of a panic attack
Chest pain shortness of breath dizziness fear of dying or losing control
What is posttraumatic stress disorder (PTSD)
A condition triggered by a traumatic event causing flashbacks nightmares anxiety and avoidance
What are signs of PTSD
Hypervigilance sleep issues irritability avoidance of reminders of the trauma
What is borderline personality disorder
A mental disorder characterized by unstable moods behavior and relationships
How might borderline personality disorder present
Intense emotional reactions impulsivity fear of abandonment self-harming behaviors
What is obsessive-compulsive disorder (OCD)
A condition marked by unwanted thoughts and repetitive behaviors
What are signs of OCD
Compulsive rituals like excessive handwashing checking things or repeated counting
What is substance-induced psychosis
Psychosis triggered by drug or alcohol use leading to hallucinations or delusions
What are key indicators of substance-induced behavioral emergencies
Sudden onset paranoia agitation hallucinations presence of drug paraphernalia
What is dementia
A progressive loss of cognitive function affecting memory reasoning and personality
How might a patient with dementia present
Confusion memory loss disorientation inappropriate behavior difficulty communicating
What is delirium
An acute temporary change in mental status often caused by illness or drugs
How does delirium differ from dementia
Delirium has a rapid onset and is reversible while dementia is gradual and progressive
What is a somatoform disorder
A condition where psychological stress presents as physical symptoms without a medical cause
How might somatoform disorder present in EMS
Chronic pain weakness or other physical symptoms that don’t align with medical findings
You arrive to find a woman pacing yelling about voices in her head and refusing to make eye contact What condition might she be experiencing
schizophrenia with auditory hallucinations
A young man is sitting silently in a dark room crying and says he’s hopeless and has no reason to live What should you immediately assess for
suicide risk and ideation
A patient is hyperactive speaking rapidly not sleeping and believes he has special powers What phase of bipolar disorder is likely
mania
You’re called to assist a man who is trembling sweating and hyperventilating and says he feels like he’s dying What is the likely cause
panic attack
An elderly woman is found wandering confused doesn’t know the date and accuses you of stealing What condition might this be
dementia or delirium
A man who survived a fire becomes agitated when you try to lead him toward flashing lights and loud sounds What might he be experiencing
PTSD trigger reaction
You’re called for a disoriented man behaving erratically and threatening others he has a strong odor of alcohol and empty bottles nearby What could be the cause
substance-induced psychosis
A woman insists she has a brain tumor despite negative tests and frequent visits to doctors for new physical complaints What condition might this indicate
somatoform disorder or illness anxiety
A patient is restrained due to severe agitation suddenly goes quiet and unresponsive What condition must you rule out
positional asphyxia or medical deterioration
A man keeps checking if his house is locked over and over and refuses to leave without doing so 20 times What condition might this behavior suggest
obsessive-compulsive disorder
You encounter a teen with visible self-harm scars who is crying and says everyone leaves her and no one cares What personality disorder may be indicated
borderline personality disorder
A woman displays disorganized speech and believes the news anchor is sending her personal messages What condition might this be
schizophrenia
You respond to a man found naked outside screaming and trying to fight responders with incredible strength What syndrome might you suspect
excited delirium
A patient is acting paranoid and aggressive and says people are after him you find meth paraphernalia nearby What might be the likely cause
meth-induced psychosis
You arrive to a quiet scene where family reports their loved one hasn’t spoken in days is not eating and lies in bed all day What might this indicate
major depressive disorder
What is your first priority when approaching a behavioral emergency
Scene safety
What should you do before entering a scene involving a potentially violent patient
Wait for law enforcement to secure the scene
What body language should you use when interacting with an agitated patient
Calm non-threatening open posture
What is the best position to talk to a patient having a mental health crisis
At eye level or lower and at a safe distance
What should you avoid doing when a patient is experiencing hallucinations
Challenging or arguing with the hallucination
How should you speak to a behavioral health patient
Slowly clearly calmly and with reassurance
Why is it important to limit the number of people talking to a behavioral patient
To reduce confusion anxiety and overstimulation
What should you always assess in patients with altered mental status
Blood glucose level and possible toxins
What should be documented in all behavioral emergencies
Patient’s behavior statements appearance and any interventions used
What is one of the most dangerous risks in behavioral emergencies
Suicide or violence toward self or others
What must be considered in patients with sudden behavioral changes
Hypoxia hypoglycemia stroke or head injury
When should restraints be used in behavioral emergencies
Only when the patient poses a danger to self or others and as a last resort
What is the EMS provider’s legal obligation in transporting a suicidal patient
Duty to act even without consent if the patient is a danger to themselves
How should a restrained patient be monitored
Continuously with frequent checks of airway circulation mental status and skin
What is an important safety rule when restraining a patient
Use enough personnel and restrain all four limbs simultaneously
When restraining a patient what position should be avoided
Prone position to prevent positional asphyxia
Why is it important to maintain a nonjudgmental attitude during a behavioral call
To build trust and avoid escalating the situation
What is a common medical condition that can mimic psychiatric symptoms
Hypoglycemia
