Treat & Refer Behavioral Health

Question 1

What will the Pt Request?

Answer 1

Help w/:

• Substance withdrawal
• Suicidal thoughts w/out active attempt or plan
• Other behavioral health
  concerns

Question 2

Requirements to Qualify

Answer 2

No Exclusion Criteria

Question 3

Most Important Factor when transferring care to another agency?

Answer 3

We are medically determining that the patient is safe for an alternative destination & does not require immediate evaluation in the ED

Question 4

Exclusion Criteria

Answer 4

• Any new medical condition, injury, or complaint requiring medical evaluation
• Any vital sign outside of range
• Suicide attempt (i.e. any ingestion, self-harm)
• Concerns for current alcohol withdrawal
• Trauma or suspected trauma
• Combative or violent behavior (i.e., behavior that poses a danger to self or others that cannot be verbally de-escalated, requiring
  physical restraints and/or chemical sedation)
• Need for IV or medication administration by EMS
• Unable to perform activities of daily living due to medical or physical limitations

Question 5

Musts for Suicidal/Unsafe Pts

Answer 5

• ED if they actively attempted self harm (OD, physical harm)
• ED if they have a reliable third party expressing suspicion
• If they report ideation w/out an attempt, AZ Crisis Intervention Services (844-534-4673) must evaluate them over the phone
• Must be accompanied by a responsible adult (over 18)
• Suicidal Pt should never be left alone!
• If they are alone & require transportation by Crisis Team, wait with patient for transportation
• When in doubt, transport patient to the ED

Question 6

Required Vital Signs

Answer 6

SBP: > 100
HR: 60-120
RR: 10-20
SpO2: > 92%
FSBG: 60-250
Temp: <100.4

Question 7

If Exclusion Criteria is Present

Answer 7

Transport to nearest ED
or
Contact Medical Direction

Question 8

What is the final thing the Pt needs to provide in order to get referral?

Answer 8

Must be caox4 & have:

• An understanding of what is going on, including risks, burdens, and benefits
• An understanding of what you are offering
• The ability to make their own decision to refuse care
• The ability to make that decision without impairment

Question 9

What is the 1st thing that must be done when calling AZ Complete Health (844-534-4673)?

Answer 9

I.D. yourself as a 911 EMS provider to expedite service

Question 10

What info needs to be relayed when doing a Warm Handoff?

Answer 10

• Provide patient’s name, age, and other useful demographics
• Provide hx of present illness
• Confirm that an evaluation of capacity has been made

Question 11

Possible Dispositions which allows units to clear scene

Answer 11

• Patient is provided all resources by Crisis Team over the phone and no longer requests transport
• Patient requires further evaluation and management at a substance abuse or behavioral health center, but is determined to be safe to wait for transportation arranged by Crisis Team