Phycological / Mental Health

Question 1

What is ABD ( acute behavioural disturbance ) (HADSS)

What should you do to maintain your/ PT/ public safety

Answer 1

Extreme mental and physiological excitement

• agitation
• delirium
• hyperthermia
• super strength
• super endurance ( no signs of fatigue)

Request police assistant

Question 2

What is considered as deliriums in patient suffering from ABD

Answer 2

Abnormal state of mind paired with significant abnormal behaviour

Confused
Running naked in public

Question 3

What risk does ABD have towards the patient

Answer 3

Significant injury + high chance of cardiac arrest up to 48 hours after period

Question 4

Why do patient with ABD have a high chance of death

Answer 4

Depletion of oxygen, glucose stores, hypercapnia, metabolic acidosis, dehydration, hyperkalemia

Question 5

Why do patient with ABD have a high chance of death

Answer 5

Depletion of oxygen, glucose stores, hypercapnia, metabolic acidosis, dehydration, hyperkalemia

Question 6

If patient is restrained by police what should you manage and why

Answer 6

• ABC
• keep PT in supine

** High chance of secondary asphyxia, and cardiac arrhythmia/ shock**

Question 7

What are the physical characteristics of ABD

Answer 7

• lack of fear
• hyperthermia
• super strength
• high endurance
• tachycardia/ tachponea
• delirium + agitation ( psychosis)
• no perspective of danger
• reduced pain perception

Question 8

What condition should you try to rule out before confirming ABD

Answer 8

• Hypoglycemia
• Hypoxia
• Significant head injury
• Psychotic disorder
• Ssri toxicity
• Substance withdrawal - tremors

Question 9

What is the management of ABD

Answer 9

-Full set of OBS ( include sats, BM, TEMP)
- verbal de-escalation
- physical restraint ( via police)
- document any restraint used
- consider chemical restraint ( RSI)
- remove cloths = hyperthermia
- CONTINUOUS ABC ASSESSMENT

Question 10

What power do police have to aid you in conveying patients who lack capacity

Answer 10

• section 136 section the patient= remove patient to a place of safety
• physical restraint

Document any restraint used - to what extent and why

Question 11

What should you document when restrain was used on a PT

Answer 11

Necessary Intervention used were in the patients best interest to prevent harm to all involved, restraint used was proportional to the threat of harm + restriction was the least restrictive to achieve safe and effective PT care

Question 12

What should be documented in patient with ABD

Answer 12

Clinical presentation, risk assessment, decision making, clinical findings, care provided