Week 5- Pyschiatric Pt's Flashcards
1
Q
Define behavioural Emergencies
A
- Abnormal behaviour that threaten’s a person health and safety or the health and safety of another
2
Q
Define Psychiatric Emergecnies
A
- Person becomes suicidal, homicidal, or has a psychotic episode
- Often experiences delusions or hallucinations that results in loss of contact with reality
- May undertake risky behaviours or become violent
3
Q
What are the causes?
A
- Loss
- Changes in relationship (ex. divorce or breakup)
- Feeling alone or like you don’t have a support system
- Switching or stopping mental health tx
- Discrimination
- Losing a job or failing a class
- Natural disaster, violence, or terroism
- Substance use
- Medical dx
4
Q
What are key social determinants of health?
A
- Access to health services
- Culture, race, and ethnicity
- Disability
- Early childhood development
- Education, literacy, and skills
- Employment, job security, and working conditions
- Food insecurity
- Gender identity and expression
- Housing
- Income and income distribution
- Indigenous status
- Personal health practices and resiliency
- Physical enviornments
- Sexual orientation and attraction
- Social inclusion, exclusion
- Social support networks
5
Q
Common Mental Health Disorders
A
- Anxiety/ depression- mood disorders
- Bipolar disorder
- Schizophrenia
- Dementia
- Excited Delirium
6
Q
What is the most common mental disorder?
A
- Anxiety
7
Q
What does generalized anxiety disorders involve?
A
- Persistent and excessive worry that interferes with daily activities
8
Q
What can trigger anxiety?
A
- Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety
- Inherited traits can also be a factor
- May be an underlying health issue
- Anxiety can be a side effect of certain medications
9
Q
What is depression?
A
- Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest
10
Q
What are the 8 signs of depression
A
- Suicidal tendency
- Insomnia
- Feel low
- Uncontrallable emotions
- Change in body weight
- Mood swings
- Hopeleness
- Anxiety
11
Q
What is bipolar disorder?
A
- Mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression)
- The exact cause of bipolar disorder is unknown
12
Q
What are some several factors may be involved with bipolar disorder:
A
- Biological differences (physical changes in their brain)
- Genetics (first-degree relative, such as a sibling or parent?
13
Q
What are bipolar disorder symptoms?
A
- Feeling overly happy for long periods of time
- Talking very fast with racing thoughts
- Becoming easily distracted
- Having overconfidence in abilities
- Engaging in risky behaviour
- Disorder includes depression episodes
- Feeling sad or hopeless for long period of time
- Significant change in appetite
- Thinking about or attempting suicide
- Feeling fatigue or lack of energy
- Problems with memory and concentration
14
Q
What is schizophrenia?
A
- Schizophrenia is a serious mental disorder in which people interpret reality abnormally
- People with schizophrenia require lifelong treatment
15
Q
What are some risk factors to schizophrenia?
A
- Having family hx
- Some pregnancy & birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development
- Taking mind-altering (psychoactive or psychotropic) drugs during teen and young adulthood
16
Q
What are early signs of schizophrenia?
A
- Nervousness
- Restlessness
- Depression
- Anxiety
- Trouble concentrating
- Unclear thinking
- Diminished self-confidence
- Low energy levels
- Severe decline in work or school performance
- Social withdrawal
17
Q
What is dementia?
A
- The loss of cognitive functioning- thinking, remembering, and reasoning- to such an extent that it interferes with a person’s daily life and activities
18
Q
What are the risk factors of dementia?
A
- High blood pressure
- Smoking
- Diabetes
- Obesity
- Lack of physical activity
- Poor diet
- High alcohol consumption
- Low levels of cognitive engagement
19
Q
What is excited delirium?
A
- Characterized by the acute onset of agitation, aggression, distress, and possibly sudden death
- Associated with the use of drugs that alter dopamine processing, hyperthermia
- Cause is not fully understood, but it is believed to be from acidosis, rhabdomyolysis, and hyperkalemia
20
Q
What are the symptoms of excited delirium?
A
- Aggressive behaviour
- Panic
- Screaming
- Increase pain tolerance
- Unexpected physical strength
- Tachypnea
- Diaphoresis
- Inappropriate clothing (nakedness)
- Reflection attraction
21
Q
What is your psychiatric assessment?
A
- Scene safety (look for evidence of weapons, drug paraphernalia, violence’ observe from a distance)
- Patient contact (interview, non-confrontational, if dealing with paranoia/ delusions reinstill reality, make sure pt is informed of physical assessment)
- Transport- do not try to overstimulate agitated pts with lights & sirens, ensure you are transporting with the the right amount of help
22
Q
FYI for Psych Pt’s
A
- Don’t leave alone
- Don’t leave stretchers in loading heights in halls at hospital- can easily tip
- Obtain vitals every 5-10 mins prn
- Manage & treat all injuries as needed
- Have police search pt. for weapons
23
Q
Can you refuse to work?
A
- Under Occupation Health and Safety Act, Section 43 (1) and (2) paramedics DO NOT HAVE THE RIGHT TO REFUSE UNSAFE WORK where circumstances are due to the inherent nature of employment
24
Q
What do BLS standards require when you arrive on scene:
A
- Identify potential hazards
- Identify a route of entry/ exit
- If there is no danger secure environment
- If danger is present contact assistance for allied agencies
25
How do you access the Scene?
- Utilize information from dispatch to judge how to approach
- Consider arriving at a distance and speaking with bystanders
- Drive by the residence to assess for potential dangers
- Proceed with caution, and understand you must make an attempt to visualize the scene
26
When are some instances where a paramedic can refuse work?
1. Continuing/ active ongoing violence
2. Dangerous weapons on scene
3. Fire or uncontained hazards
4. Directed to so by FD/PD/Management or CACC
27
Consent and Capacity
- A person is deemed to have capacity if they understand the relevant information that is required for making a decision and are able to appreciate the reasonably foreseeable consequences of a decision or lack of a decision
28
How do we restrain pt's?
- Always restrain supine with police present
29
How far can a taser probe reach?
- Fires two probes up to a distance of 21 feet from an air catridge
- Effective range is 6-12 feet
- Top probe deploys straight from the cartridge following the laser sight from the gun while the bottom probe drops 1 foot every 7 feet of travel
30
How does a taser probe work?
- Does not damage nervous tissue or the CNS
- Does not affect involuntary muscle groups
- Has no effect on cardiac tissue or heart rhythm
31
How do we remove a probe from a pt?
- Police may take photos of injuries pre & post dart removal (evidence)
- You need to remove darts before the transport
- Stretch the skin and pull probe out with a quick jerk in a vertical direction
- Inspect the probe carefully to ensure it is intact
- Inspect the site of the wound to ensure there is nothing still embedded
- Clean and cover with a bandaid
32
When do we not remove darts?
- Head/ face
- Neck
- In the nipples
- Groin
- Bone
- Pt. <16 yrs of age
- Pt. refuses to let you remove
- Secure darts in place
33
