Mental Health Emergencies

Question 1

What is the term “chemical restraints” mean in the presence of prehospital environment?

Answer 1

The use of medication to sedate a patient that is exhibiting extreme agitation or aggressive, and or violent behavior. Paramedics will only use this when a patient is a risk to themselves or others, and cannot be safely managed through other means.

Question 2

What underlying etiologies could cause extreme agitation or violence that should be treated prior to chemical restraints?

Answer 2

Hypoxia, hypoglycemia, head injury, drug interactions, infections, electrolyte, and balances

Question 3

what medication is used for an excited delirium syndrome patient?

Answer 3

Ketamine

Question 4

what is the dosage for ketamine in delirium syndrome?

Answer 4

4 to 5 mg per kilogram intramuscular

Question 5

what is the max amount of milliliters you can inject intramuscularly into muscles of a patient?

Answer 5

Deltoid 2 mL
Lateral thigh 4 to 5 mL
Gluteus maximus 5 mL

Question 6

where is the preferred spot to administer ketamine during an delirium syndrome?

Answer 6

Lateral thigh or gluteus maximus

Question 7

is Midazolam appropriate to use during excited delirium syndrome emergencies?

Answer 7

Yes, as a rass +2 or 3

Question 8

At what rass can ketamine be used for an excited delirium patient?

Answer 8

+4