Chapter 23 Behavioral and Psychiatric Emergencies and Suicide

Question 1

Behavior

Answer 1

The manner in which a person acts

Question 2

Behavioral emergency

Answer 2

When a patient’s behavior is not typical for the situation; when the patient’s behavior is unacceptable or intolerable to the patient, his family, or the community; or when a patient may harm himself or others

Question 3

According to the national Institute of mental health 2013 statistics

Answer 3

• 65.1 million Americans suffer from a diagnosable mental disorder
• Almost 7% of the population has a mood disorder (depression)
• Slightly more than 18% have anxiety or panic issues
• 1.1% are involved for conditions such as schizophrenia
• 2.6% involved in bipolar disorder
• About 9.2 million adults have co-occurring mental health and addiction disorders

Question 4

Physical causes of altered mental status

Answer 4

• Low blood sugar
• lack of oxygen stroke or in adequate
• blood to the brain
• head trauma
• mind altering substances
• environmental temperature extremes

Question 5

Acute psychosis

Answer 5

Occurs when the patient develops one or more of the following symptoms: Hallucinations, delusions, catatonia, or I thought disorder

Question 6

Hallucinations

Answer 6

Are inappropriate sensory observation such as vision or voices

Question 7

Delusion

Answer 7

Are falsely held beliefs such as paranoia, the belief that one is being persecuted when that is not the case

Question 8

Catatonia

Answer 8

Characterized by either an almost complete non-interaction with the environment or wild and completely inappropriate movements and interactions

Question 9

Thought disorder

Answer 9

Impact a patient’s ability to process information and to communicate and can cause unusual speech patterns or strange writing

Question 10

Providing a caring and compassionate setting while maintaining control is essential. Key techniques to consider

Answer 10

• Identify yourself and roll.
• Speak slowly and clearly. Use a calm and reassuring tone
• Make eye contact with patient
• Listen to the patient you can show you are listening by repeating part of what the patient says back to him
• Do not be judge mental. Show compassion not pity
  Use positive body language
• Do not enter the patient’s personal space stay at least 3 feet from the patient
• be Alert for changes in patient’s emotional status
• Use restraints to prevent harm if necessary

Question 11

Selective serotonin reuptake inhibitor (SSRI)

Answer 11

Medication believed to elevate mood by preventing the reuptake of the neurotransmitter Serotonin in the synapse

Question 12

Suicide

Answer 12

8th leading cause of death, but the third leading cause of death in age groups ranging from 15-24 and over the age of 40

Question 13

Precautions for: Aggressive or hostile patients

Answer 13

1. Do not isolate yourself from your partner or other resources, make certain that you have an escape route
2. Do not take any action that may be considered threatening
3. Always be on the watch for weapons

Question 14

Reasonable force and restraint

Answer 14

Is the force necessary to keep a patient from injuring himself or others
• determined by circumstances involved, patient strength and size, type of abnormal behavior, mental status, and available methods

Question 15

Excited delirium

Answer 15

Bizarre and/or aggressive behavior, shouting, paranoia, panic, violence toward others, and sensitivity to pain, unexpected physical strength, and hyper thermia, usually associated with cocaine or amphetamines. Also called agitated delirium

• May be followed by patient Abruptly stopping and found to have in adequate or absent respirations

Question 16

Positional asphyxia

Answer 16

In adequate breathing or respiratory arrest caused by a body position that restricts breathing

Question 17

Medical/legal considerations

Answer 17

Most states have a provision in law that will allow a patient to be transported against his will if he is a danger to himself or others

• Always contact medical direction
• if possible, EMTs of the same sex as the patient should attend to the emergency care of disturbed patients
• For aggressive or violent patient, make sure law-enforcement officers accompany you to the hospital