EC Chp 23 Behavioral & Psychiatric Emergencies & Suicide Flashcards
Behavioral emergency exists when
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.
A key part of the definition of behavior emergency is…
“Within a given situation”
About how many people were diagnosed with a mental disorder in 2013
1 in 4 or about 65.1 million people
Name the different Psychiatric conditions
Mood Disorder : depression
Anxiety or panic Issues
Schizophrenia and Bipolor disorder.
Addiction disorders
Physical causes of altered mental status or (non-psychiatric causes)
- 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
When faced with severe, unexpected stress, most patients will display emotions such as:
Fear
Grief &
Anger
In situational stress reactions as an EMT how you should you deal with your patient?
- 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.
Acute Psychosis is a severe break in patients abilities to process information and interact in their environment. This is often develops symptoms such as…
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
Remember with Psychiatric emergencies, it is generally important to…
Provide a professional and calm atmosphere. After of course you ensure the scene is safe.
How far should you stay away from a patient with a Behavioral or Psychiatric emergency?
At least 3ft from the patient. Do NOT enter the patients personal space or make the patient feel enclosed
Signs and symptoms of patients experiencing Psychiatric emergencies:
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
What is reuptake?
Process of which the neurotransmitter is returned tot he presynaptic neuron.
Selective Serotonin Reuptake Inhibitor (SSRI) are commonly prescribed class of drugs for
Mental disorders and depression
Examples: Prozac, Paxil, and Zoloft
Newer medication offer reuptake inhibition of more than one neurotransmitter. In addition to Serotonin others include:
Norepinephrine, epinephrine and dopamine.
The nervous system works through the use of neurotransmitters. Electrical pulses travel along neurons until they reach a….
Synapse (space between nerve cells)
Neurotransmitters are chemicals within he body that transmit the message from _____ to ______
Distal end of one neuron (presynaptic) to the Proximal end of the next neuron (Postyaptic)
What is the 3rd leading cause of death for age group of 15-24 years old?
Suicide
For potential or attempted suicide, in all cases what is key?
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
For aggressive or hostile patients it is important to…
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
Reasonable force is necessary to keep a patient from….
Injuring himself or others.
All Circumstances must be looked at to be determined its necessary
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…
It can inflict soft- tissue damage.
You must avoid actions that can cause injury to the patient
Excited Delirium (agitated delirium) refers to a condition where
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.
When restraining a patient you should have a minimum of how many people and in what position
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.
Emotionally disturbed patients sometimes accuse EMS personnel of sexual misconduct. Because of this…
If Possible EMT’s of the same sex as the patient should attend to the emergency care of disturbed patients.
