EC Chp 23 Behavioral & Psychiatric Emergencies & Suicide

Question 1

Behavioral emergency exists when

Answer 1

A person exhibits abnormal behavior that is not typical for within a given situation. The given situation that is unacceptable or intolerable to the patient, family or the community.

Question 2

A key part of the definition of behavior emergency is…

Answer 2

“Within a given situation”

Question 3

About how many people were diagnosed with a mental disorder in 2013

Answer 3

1 in 4 or about 65.1 million people

Question 4

Name the different Psychiatric conditions

Answer 4

Mood Disorder : depression
Anxiety or panic Issues
Schizophrenia and Bipolor disorder.
Addiction disorders

Question 5

Physical causes of altered mental status or (non-psychiatric causes)

Answer 5

• Low Blood sugar: rapid onset of erratic behavior (diabetes)
• Lack of Oxygen: restlessness and confusion
• Stroke or inadequate blood to the brain: confusion or dizziness, function loss
• Head Trauma
• Mind altering substances
• Environmental temp extremes: ex. Excessive cold

Question 6

When faced with severe, unexpected stress, most patients will display emotions such as:

Answer 6

Fear
Grief &
Anger

Question 7

In situational stress reactions as an EMT how you should you deal with your patient?

Answer 7

• Do NOT Rush - be as unhurried as you can.
• Let the patient know that you are there to Help
• Act in a calm manner to give patient time to gain control of emotions
• Let the patient know that you are listening

These are called Crisis Management Techniques.

Question 8

Acute Psychosis is a severe break in patients abilities to process information and interact in their environment. This is often develops symptoms such as…

Answer 8

Hallucinations- inappropriate sensory visions or voices
Delusions - falsely held beliefs, paranoia
Catatonia- almost complete no interaction with environment “the stare”
Thought Disorder- cause unusual speech patterns or strange writing

Question 9

Remember with Psychiatric emergencies, it is generally important to…

Answer 9

Provide a professional and calm atmosphere. After of course you ensure the scene is safe.

Question 10

How far should you stay away from a patient with a Behavioral or Psychiatric emergency?

Answer 10

At least 3ft from the patient. Do NOT enter the patients personal space or make the patient feel enclosed

Question 11

Signs and symptoms of patients experiencing Psychiatric emergencies:

Answer 11

Panic or Anxiety.
Unusual appearance, disordered clothing or poor hygiene
Agitated or unusual activity, repetitive motions, threatening movements
Unusual Speech patterns
Bizarre behavior
Suicidal or self-destructive behavior
Violent or aggressive behavior

Question 12

What is reuptake?

Answer 12

Process of which the neurotransmitter is returned tot he presynaptic neuron.

Question 13

Selective Serotonin Reuptake Inhibitor (SSRI) are commonly prescribed class of drugs for

Answer 13

Mental disorders and depression

Examples: Prozac, Paxil, and Zoloft

Question 14

Newer medication offer reuptake inhibition of more than one neurotransmitter. In addition to Serotonin others include:

Answer 14

Norepinephrine, epinephrine and dopamine.

Question 15

The nervous system works through the use of neurotransmitters. Electrical pulses travel along neurons until they reach a….

Answer 15

Synapse (space between nerve cells)

Question 16

Neurotransmitters are chemicals within he body that transmit the message from _____ to ______

Answer 16

Distal end of one neuron (presynaptic) to the Proximal end of the next neuron (Postyaptic)

Question 17

What is the 3rd leading cause of death for age group of 15-24 years old?

Answer 17

Suicide

Question 18

For potential or attempted suicide, in all cases what is key?

Answer 18

Your personal interaction - verbal and visual contact ASAP
The more reassurance you can provide the patient the easier it will be for emergency department staff to continue care.
Transport ALL suicidal patients

Question 19

For aggressive or hostile patients it is important to…

Answer 19

Ensure the scene is safe,
Look for clues at the scene in regards to persons mental status
Neighbors or family
The Patients STANCE (tense muscles, fists clenched, or quick irregular mov)
Make sure you have an escape route
Seek Medical direction if patients behavior prevents normal assessment & care

Question 20

Reasonable force is necessary to keep a patient from….

Answer 20

Injuring himself or others.

All Circumstances must be looked at to be determined its necessary

Question 21

If you help the police or a physician restrain a patient make sure the restraints are humane. For example criminal restraints should not be used because…

Answer 21

It can inflict soft- tissue damage.

You must avoid actions that can cause injury to the patient

Question 22

Excited Delirium (agitated delirium) refers to a condition where

Answer 22

A patient begins to act extremely agitated or psychotic toward others. Insensitivity to Pain, unexpected strength and hyperthermia. Usually associated with Cocaine and amphetamine use.

Question 23

When restraining a patient you should have a minimum of how many people and in what position

Answer 23

Minimum of 4 people (one for each limb) and position the patient face up in the supine position.

• Constantly monitor the patient
• Document the reasons for restraining.

Question 24

Emotionally disturbed patients sometimes accuse EMS personnel of sexual misconduct. Because of this…

Answer 24

If Possible EMT’s of the same sex as the patient should attend to the emergency care of disturbed patients.