Chapter 22-Psychiatric Emergencies Flashcards by best person

What are the safety guidelines for responding to behavioral crises and psychiatric emergencies?

Assess scene
Ensure you have means of communication
Locate exits
BSI
Identify yourself
Try to de-escalate patient's agitation 
Don't get too close to patient
Don't leave patient
Don't fight with patient

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Define psychosis

A state of delusion in which the person is out of touch with reality

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What are three causes of psychotic episodes?

Substances
Diseases
Stress

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What factors influence schizophrenia?

Genetics, psychological and social influences

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What are signs and symptoms of schizophrenia?

erratic speech, delusions, hallucinations, disinterest in pleasure

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What is excited delirium?

A state of cognitive impairment involving hallucinations, disorientation, and delusions

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What are the physical signs of excited delirium?

Hypertension, tachycardia, diaphoresis, dilated pupils

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What should you do when treating a patient in excited delirium?

Don’t touch the patient
Ask basic questions to gauge mental status
Take all bottles/containers if drugs suspected
Refrain from using sirens/bright lights
Consider calling ALS for chemical restraint

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What can cause sudden death in patients experiencing excited delirium?

Metabolic acidosis
Physical control measures (taser)
positional asphyxia (patient is restrained in a position that blocks their airway

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How do you assess the potential violence of a patient?

Scene (broken windows)
History (violence in past)
Position (tense, rigidity, etc.)
Vocal activity
Physical activity

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Signs of suicidal intentions?

Depression
Family history
Loss of loved one
Financial setback
Isolation
No eye contact
Self-harm

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What is normal body temperature?

98 degrees F

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What are the five ways in which heat can travel?

Conduction
Convection
Radiation
Evaporation
Respiration

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Define conduction

Heat passing between objects via direct contact

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Define convection

Heat transfer between an object and circulating air

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Define radiation

Heat transferred by radiant energy

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Define evaporation

Heat lost from an object when water evaporated from its surface

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How is heat transferred during respiration?

Warm air leaves the lungs and cool air comes in

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Heat loss can be modified in three ways:

Body increases or decreases heat production
Body is moved to an area that prevents or promotes heat loss
Appropriate clothing for conditions

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Define drowning

The process of experiencing respiratory impairment from submersion in a fluid

What are risk factors for drowning?

alcohol
age (infant or geriatric)
seizure disorders
unsupervised access to water

When even a small amount of water is inhaled, what happens in the body?

Spam of the larynx and vocal chords (laryngospasms)

What is the purpose of laryngospasms?

to prevent more water from entering the lungs

What happens if laryngospasms hinder ventilation?

The patient becomes hypoxic and loses consciousness, at which point the laryngospasms stop

In what situations should you associate drowning with spinal injury?

- the patient dove or fell from a tall height - the patient is unconscious - patient reports numbness/weakness/paralysis

How do you stabilize the c-spine of a drowning patient?

``` Place in supine position open airway and start ventilations slide a buoyant backboard under patient Secure head and trunk to backboard remove patient from water cover with blanket begin CPR ```

What are two mechanisms that the body has for ridding itself of excess heat?

Sweating and dilation of blood vessels in the skin

What temperature is the body at to be considered hyperthermic?

101 degrees F

What is a heat emergency?

when the body's mechanisms for ridding itself of heat are overwhelmed

What two things make heat emergencies worse?

Humidity (reduces efficiency of sweating) and warm air temperature (reduces heat loss by radiation, which is the purpose of dilating superficial blood vessels)

What are the three types of heat emergencies?

Heat cramps, heat exhaustion, and heat stroke

What is the most common heat emergency?

Heat exhaustion

What are heat cramps?

Painful muscle spasms in the legs or abdominal muscles that occur after vigorous exercise due to electrolyte imbalance/loss or dehydration

What is heat exhaustion?

a heat emergency caused by stress, fatigue, hypovolemia, and/or heat exposure

What are the sign and symptoms of heat exhaustion?

``` dizziness/fainting/weakness onset with work cold clammy skin dry tongue and thirst weak/rapid pulse low BP elevated body temp ```

What is heat stroke?

A heat emergency in which the body temperature rises above the level at which tissue damage occurs, resulting in death

What are the signs and symptoms of heat stroke?

``` Hot/dry/flushed skin Body temp above 106 rapid/strong pulse at first but becomes weaker late onset respiratory rate AMS sweating may have stopped ```

How many people are killed by lightning each year in the states?

60-70

How many volts are delivered by lightning?

100 million

What is the temperature range associated with lightning?

20,000-60,000 degrees F

Who are common victims of lightning strikes?

Golfers, boaters, and swimmers

Lightning related deaths often result from _____

cardiac arrest or respiratory arrest

Lightning injuries can be categorized as:

mild, moderate, severe

What are the signs and symptoms of mild lightning injuries?

unconsciousness amnesia superficial burns (if any) tingling

What are the signs and symptoms of moderate lightning injuries?

Seizures respiratory arrest dysrhythmias superficial burns

What are the signs and symptoms of severe lightning injuries?

cardiopulmonary arrest

What is the emergency medical care for lightning strike accidents?

- Your safety (crouch and move away from tall objects) - Move patient to shelter - Reverse triage (cardiac arrest first) - Stabilize head - Open airway with jaw-thrust maneuver - BVM with 100% O2 - CPR/AED - Control bleeding - Bandage burns en route

Why is it important to stabilize the patient's head following lightning strike?

The current causes muscle spasms which can cause fractures in long bones or the spine