Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EMT > Chapter 22 > Flashcards

Chapter 22 Flashcards

You may prefer our related Brainscape-certified flashcards:
NREMT® EMT flashcards
1
Q 
psychiatric emergencies may be the result of: 
acute .. situation 
… 
… substances
… 
other causes
A

medical; mental illness; mind-altering; stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

… is what you can see of a person’s response to the environment: his/her actions
most of the time, people respond to the enviro in reasonable way. over time, people learn to adapt to stress
sometimes stress is so great that the normal ways of coping don’t work and a crisis occurs. reactions to stress can be … or … over time.

A

behavior; acute; develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a behavioral crisis or psychiatric emergency may involve patients who exhibit agitated, violent, or uncooperative behavior or who are a danger to themselves or others. EMS is called when behavior has become …to patient, family, or community

A

unacceptable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

if an abnormal or disturbing pattern of behavior lasts for a month or more, it is a matter of … from a mental health standpoint.
when a psychiatric emergency arises, the patient may:
1. show .. or …
2. become a … to self or others

A

concern; agitation; violence; threat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

According to the National institute of Mental Health, mental disorders are common throughout the United States, affecting tens of millions of people each year. A psychiatric disorder is an illness with … or … symptoms that may result in impaired functioning

A

psychological; behavioral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

anxiety disorders are among the most common health disorders:

  • generalized …
  • … disorder
  • … and other phobias
  • …
  • …
A 
anxiety disorder
panic
social 
PTSD
OCD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

the US mental health system provides many levels of assistance.
most psychological disorders can be handled through … visits
some people require hospitalization in … units

A

outpatient; specialized psychiatric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

psychiatric disorders have many underlying causes:

  • … and … stress such as divorce or death of a loved one
  • diseases such as …
  • … such as diabetic emergencies
  • .. problems such as alcohol or drug use
  • .. disturbances such as electrolyte imbalances
A 
social; situational 
schizophrenia 
physical illnesses 
chemical 
biological
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

an EMT is not responsible for diagnosing the … of a behavioral crisis or psychiatric emergency.
two basic categories of diagnosis: … (physical) and .. (psychological)

A

underlying cause; organic; functional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

… brain syndrome: a temporary/permanent dysfunction of the brain caused by a disturbance in the physical or physiologic functioning of the ..

A

organic; brain tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

causes of organic brain syndrome:
- sudden ..
- traumatic ..
- … disorders
- … and … abuse, overdose, or withdrawal
- diseases of the …, such as Alzheimer’s and meningitis
in the absence of a physiologic cause, altered mental status may be an indicator of an underlying psychiatric disorder

A 
illness 
brain injury
seizure
drug; alcohol
brain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

… disorders: a physiological disorder that impairs bodily functions when the body seems to be structurally normal
examples: schizophrenia, anxiety conditions, depressions

A

functional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

All regular EMT skills are used in a behavioral crisis. other management techniques are also involved. Scene safety:
consider the scene safety and the patient’s … to the environment
take appropriate standard precautions
request any additional resources you may need early

A

response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MOI/NOI

note any … or … that may contribute to the complaint or be treatment of a relevant medical condition

A

medications; substances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

primary assessment:
form a general impression:
begin your assessment from the doorway or from a …
perform a rapid physical exam
observe patient closely
establish a rapport with patient and family
most medical/trauma situations will include a behavioral component

A

distance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

primary assess cont:
airway and breathing
circulation
transport decision: unless the patient is unstable from a medical problem or trauma, prepare to … with the patient

A

spend time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

History taking:
investigate the chief complaint
three major areas to consider:
- is the patient’s … functioning properly?
- are … or other drugs or alcohol a factor?
- are significant …, …, or … involved?

A

central nervous system
hallucinogens
life changes; symptoms; illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

history taking cont:
SAMPLE history–> You may be able to elicit info not available to the hospital staff: ask about previous episodes, treatments, hospitalizations, and medications related to behavioral problems
in geriatric patients, consider Alzheimer disease and dementia as possible causes of abnormal behavior–> identify the patient’s … mental status
use … listening to gain insight into the patient’s thinking

A

baseline; reflective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

secondary assessment:
physical exam–> in an unconscious patient, begin with a … to look for a reason for the unresponsiveness: rule out trauma, especially to the head; consider whether prior events such as physical agitation, use of stimulants, alcohol withdrawal, or Taser exposure may be contributing to the patient’s condition
when examining a patient with a behavioral emergency, check for track marks indicating … and for signs of ..
a conscious patient may not respond to your questions

A

physical exam; drug abuse; self-mutilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

physical exam (contd):
you can tell a lot about a patient’s emotional state from:
- …
- …
- …
tears, sweating, and blushing may be significant indicators of state of mind.
a …. gaze or … eyes could mean central nervous system dysfunction

A

facial expressions
pulse rate
respirations
blank; rapidly moving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

transport decision:
have law enforcement/firefighters accompany you if possible
take the patient to a facility capable of caring for patients with psychiatric problems
transport the patient by ..
try to make the patient comfortable

A

ground

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Reassessment:
never let your guard down
if restraints are necessary, reassess and document every … minutes: …, …, .., and … function in all restrained extremities

A

5; respirations; pulse; motor; sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

interventions:
diffuse and control the situation
intervene only as much as it takes to accomplish these tasks
if you think a pharmacologic restraint is necessary, request .. as early as possible

A

ALS assistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

communication and documentation:
give the receiving hospital … of the psychiatric emergency–> report whether restraints will be required when the patient arrives
document thoroughly and carefully: if restraints are used, identify which types and … they were used

A

advance warning; why

25
Q

…: a state of delusion in which the person is out of touch with reality–> affected people live in their own reality of ideas and feelings
may cause psychotic episodes

A

psychosis

26
Q

schizophrenia is a complex disorder that is not easily defined/treated
the typical onset occurs during early …, with symptoms becoming more prominent over time
signs and symptoms:
…
…
a lack of interest in ..
… speech

A 
adulthood; 
delusions
hallucinations 
pleasure
erratic
27
Q 
guidelines for dealing with a psychotic patient: 
determine if the situation is dangerous
clearly … yourself
be calm, direction, and straightforward
maintain an … 
do not …
A

identify; emotional distance; argue

28
Q

guidelines for dealing with a psychotic patient contd:
explain what you would like to do
involve people the patient …, such as family/friends, to gain the patient’s cooperation

A

trusts

29
Q

…: a condition of impairment in cognitive function that can present with disorientation, hallucinations, or delusions
…: a behavior characterized by restless and irregular physical activity

A

delirium

agitation

30
Q

excited delirium symptoms:

  • … behavior
  • vivid ..
  • …
  • …
  • ..
  • … pupils
A 
hyperactive irrational 
hallucinations 
hypertension 
tachycardia
diaphoresis 
dilated
31
Q

excited delirium:
if you think you can safely approach the patient, be calm, supportive, and empathetic
approach the patient … and purposefully and respect the patient’s …
limit …
do not leave the patient …

A

slowly; personal space; physical contact; unattended

32
Q

excited delirium contd:
use careful interviewing to assess the patient –> observe the patient’s ability to …, their …, …, and …
if the patient has overdosed, take all med bottles/illegal substances to the med facility
the patient should be transported to a hospital with psychiatric facilities if possible
refrain from using … and …

A

communicate; appearance; dress; personal hygiene; lights; sirens

33
Q

if the patient’s agitation continues, request ALS assistance so … can be considered–> uncontrolled/poorly controlled patient agitation can lead to the patient’s sudden death

A

chemical restraint

34
Q

excited delirium can lead to sudden death from:
sudden …
physical agitation, thought to result from …
… measures (including tasers)
positional …

A

cardiopulmonary arrest
metabolic acidosis
physical control
asphyxia

35
Q

Restraint:
every prehospital care transport provider should create and follow a prehospital patient restraint protocol. Protocols address:
… of restraint
… of restraints
… provided to the patient following restraint
protocols must comply with the laws of your state
the restraint chosen should be the least restrictive option that ensures the safety of the patient and providers

A

appropriateness; types; care

36
Q

restraint cont:
personnel must be properly trained
if you restrain a person without authority in a .. situation, you expose yourself to a possible lawsuit: assault, battery, false imprisonment, violation of civil rights
improper use of restraints can lead to life-threatening conditions including …

A

nonemergency; cardiac arrest

37
Q

restraint cont:
you may use restraints only:
to protect yourself/others form …
to prevent the patient from … himself/herself

A

bodily harm; injuring

38
Q

restraint cont: involve law enforcement if the patient is in a severe … crisis or … emergency
before considering physical restraint, use … de-escalation techniques

A

behavioral; psychiatric; verbal

39
Q

restraint cont:
process of restraining a patient:
carry out the decision quickly
there should be … people to help, one responsible for each … and one for the …
there should be a team leader and plan of action
use the minimum force necessary

A

5; extremity; head

40
Q

restraint cont:
the level of force will vary, depending on these factors:
the degree of force that is necessary to keep the patient from injuring self and others
the patient’s …, …, .., and … status
the type of abnormal behavior the patient is exhibiting

A

sex
size
strength
mental status

41
Q

restraint cont:
… to the patient throughout the process
treat the patient with dignity and respect
if possible, a provider of the same … should attend to the patient
wear appropriate .. protection

A

talk; gender; barrier

42
Q

restraint cont:
avoid direct … and respect personal space
never leave a restrained person ..
… restraints (both arms and both legs) are preferred
monitor the patient closely–> respiratory and circulatory problems have been known to occur in restrained patients
restraints applied in the field should not be removed until the patient is evaluated at the receiving facility

A

eye contact; unattended; four-point restraints

43
Q

(potentially violent patient)

history: has the patient previously exhibited hostile, overly aggressive, or … behavior?
posture: how is the patient … or …? is the patient tense, rigid, or sitting on the edge of his/her seat?

A

violent; sitting; standing

44
Q

(potentially violent patient)
the scene: is the patient holding or near potentially … objects?
vocal activity: which kind of … is the patient using?
loud, obscene, erratic, and bizarre speech patterns usually indicate emotional distress

A

lethal; speech

45
Q

(potentially violent patient) physical activity: most telling factor of all
a patient requiring careful watching is one who:
has .. muscles, clenched fists, or glaring eyes
is …
cannot …
is fiercely protecting …

A

tense; pacing; sit still; personal space

46
Q

(potentially violent patient) other factors to consider:
poor … control
history of truancy, fighting, and uncontrollable temper
history of …
…
… disorder (if the patient tells you voices are telling him/her to kill, believe it)

A

impulse; substance abuse; depression; functional

47
Q

suicide:
…. is the single most significant factor that contributes to suicide
it is a common misconception that people who threaten suicide never commit it–> threatening suicide is an indication hat someone is in a crisis that he/she cannot handle alone
immediate intervention is necessary

A

depression

48
Q

suicide cont:
be alert to these warning signs:’
air of tearfulness, sadness, deep despair, or hopelessness
avoiding …, speak …, and project a sense of vacancy
unable to talk about the future
suggestion of suicide
having any plants related to death

A

eye contact; slowly

49
Q 
suicide cont: 
consider these additional risks: 
are there any … objects nearby? 
is the environment unsafe? 
is there evidence of … behavior? 
is there an imminent threat to the person/others?
A

unsafe; self-destructive

50
Q 
suicide cont: 
is there an underlying … problem? 
are there cultural/religious beliefs promoting suicide? 
has there been …? 
a suicidal patient may be … as well
A

medical; trauma; homicidal

51
Q

(PTSD) an estimated 7 to 8% of the gen pop will experience PTSD at some point in their lives.
military personnel who have experienced … have a high incidence of PTSD. Symptoms of PTSD include feelings of: helplessness, anxiety, anger, fear

A

combat

52
Q

(PTSD) people with PTSD: may avoid … of the trauma
suffer constant … –> heart rate increases, pupils dilate, and systolic blood pressure increases
can relive the traumatic event through thoughts, nightmares, and flashbacks

A

reminders; nervous system arousal

53
Q

(PTSD) .. have an increased risk of suicide
veterans may develop a variety of physical conditions related to combat injuries
combat veterans have a higher incidence of …
health care providers should eliminate excess noise, refrain from touching/doing anything to the veteran without an explanation, and keep their … equipment far away

A

veterans; traumatic brain injury; diesel

54
Q 
(PTSD) caring for the combat veteran: 
requires a unique level of understanding: 
be careful how you … your questions
use a clam, firm voice, but be in … 
respect a veteran's … 
limit the number of people involved
ask about suicidal intentions
A

phrase; charge; personal space

55
Q

(PTSD) caring for the combat vet: ‘
ensure that there is nothing the patient can access and use as a weapon
… may simply escalate the problem

A

physical restraints

56
Q

more complicated with a patient undergoing behavioral crisis/psychiatric emergency
you must decide wether the patient needs immediate emergency medical care: ‘
the patient may … your attempt to provide care
never leave the patient alone
request … personnel to assist with the patient

A

resist; law enforcement

57
Q

… is assumed with a patient who is not mentally competent to grant consent
consent matters are not always clear-cut in psychiatric emergencies–> if you aren’t sure, request the assistance of … or guidance from …

A

implied consent; law enforcement; medical control

58
Q

the emt has limited legal authority to require a patient to undergo emergency med care when no … exists
competent adults have the right to refuse care

A

life-threatening emergency

59
Q

in psychiatric acases, a court of law would probably consider your actions in providing … to be appropriate–> a patient who is in any way impaired may not be considered competent
maintain a high index of suspicion about the patient’s condition
err on the side of … and …

A

life-saving care; treatment; transport

EMT (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions