Violence, aggression, legislation & psychosis management Flashcards

1
Q

management of aggressive behaviour (3 steps)?

A

prediction
(body language)

Prevention
(De-escalation, observations, room layout)

intervention
(restraint, seclusion, rapid tranquillisation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Scottish mental health act:

-who can use it?

A

-Any registered practitioner for Emergency detention

Approved medical practitioner for short term detention and compulsory treatment order

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Emergency detention

  • when used?
  • by who?
  • last for how long?
  • what criteria must patient meet?
  • right of appeal?
  • is treatment authorised?
A
  • where it is necessary as a matter of urgency to detain the patient in hospital for the purpose of permitting a full assessment of the person’s mental state; and where if the patient were not detained in hospital there would be a significant risk to either themselves or others”
  • a registered medial practitioner, usually with consent of MHO (but can proceed without if urgent)
  • 72 hours
  • ability to make decisions for treatment of mental disorder must be significantly impaired
  • No
  • No, unless emergency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Short term detention

  • applied by who?
  • requires who to consent?
  • treatment authorised?
  • lasts for how long?
  • right to appeal?
  • what criteria must patient meet? (4)
A
  • an approved medical practitioner
  • MHO
  • yes
  • max 28 days
  • yes

-patient has mental disorder
patient’s ability to make decisions about provision of treatment is significantly impaired as a result
necessary to detain the patient in hospital for to determine treatment or to give treatment
would be a significant risk to the health/safety/welfare of patient or another person if the patient not detained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Compulsory treatment order

  • who makes the application?
  • can they appeal?
  • treatment authorised?
  • what is required?
  • lasts how long?
A
  • MHO supported by 2 medical reports, one of whom must be an AMP
  • yes
  • yes
  • a tribunal hearing
  • up to 6 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Rapid tranquillisation policy

what are the stages? (6-6)

A

consider non-drug approaches:
distraction, seclusion, try talking to patient

IF confirmed hx of significant typical antipsychotic exposure then:
->Oral lorazepam (1-2mg) and/or haloperidol 5mg
-> oral unsuccessful
->injected Lorazepam 1-2mg IM
extreme= lorazepam and haloperidol 5mg IM
(monitor resp rate, pulse BP)
->wait 30 mins and repeat

OR Hx unknown, cardiac disease, no hx typical antipsychotics, current illicit drug use:

  • > oral lorazepam -2mg
  • > oral unsuccessful
  • > consider injection lorazepam 1-2mg IM
  • > wait 30 mins and repeat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

pharmacological management of psychosis?

  • what might be used if compliance issue? resistant?
  • if competed with mood disorder?
A

Use antipsychotics
-is there an advanced treatment order?
atypical usually first line

-depot
clozapine

-mood stabilisers, antidepressants, ECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly