CHAPTER 23 Behavioral Emergencies Limmer et al., Emergency

CHAPTER 23 Behavioral Emergencies Limmer et al., Emergency

CHAPTER 23 Behavioral Emergencies Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Causes of

Behavioral Change Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Key Term Behavior The manner in which a person acts or performs

Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Key Term Behavioral Emergency A situation in which the patient exhibits abnormal behavior within a given situation that is unacceptable or intolerable to the patient, family, or community

Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Causes of Behavioral Change Low blood sugar Lack of oxygen Inadequate blood flow to brain or stroke Head trauma Continued

Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Causes of Behavioral Change Mind-altering substances Excessive heat or cold Psychological crises Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Psychological Crises Panic Agitation Bizarre thinking and behavior Danger to self Danger to others Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Behavioral Emergencies Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Behavioral Emergencies Actions to Take Size up scene carefully.

Identify yourself, your role. Inform patient what you are doing. Ask questions in a calm, reassuring voice. Do not rush. Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Behavioral Emergencies Actions to Take Do not be judgmental. Acknowledge patients feelings. Show you are listening by rephrasing what is said. Treat patient with respect.

Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Assessing Behavioral Emergencies What is the patients mental status? Appearance (clothing, hygiene) Activity Speech Orientation

Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Assessing Behavioral Emergencies Any potential violence? History of violent behavior Posturing Voice level/tone Physical activity

Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Emergency Care for Behavioral Emergencies Maintain a comfortable distance. Encourage patient to talk. Do not make quick moves. Respond honestly to questions. Continued

Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Emergency Care for Behavioral Emergencies Do not threaten, challenge, or argue. Do not play along with visual or auditory disturbances. Involve trusted family or friends.

Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Emergency Care for Behavioral Emergencies Be prepared to spend time with patient. Avoid unnecessary physical contact.

Use positive eye contact. Restrain if necessary. Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Suicidal Behavior Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Suicide Risk Factors 15-25 years old, or over 40 years old, are high risk, but any age is possible Alcohol or drug abuse Lethal plan of action Gathering articles capable of causing death (gun, pills, etc.) Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Suicide Risk Factors Depression or high stress levels Previous history of self-destructive behavior Recent diagnosis of serious illness Recent loss of loved one Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Suicide Risk Factors Arrest, imprisonment, loss of job Sudden improvement from depression Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Size-Up During Suicidal Behavior Any display of self-destructive

behavior or thoughts? Illness or injury from previous attempts? Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Size-Up During Suicidal Behavior

How does patient feel? Is patient a threat to self/others? Is there a medical problem? Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Safety Considerations Have an escape route. Never enter a scene alone. Be alert for weapons or potential

weapons. Watch for sudden changes of behavior. Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Emergency Care for Suicidal Behavior Size up scene and your safety concerns.

Utilize police department as needed. Perform patient assessment. Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Emergency Care for Suicidal Behavior Calm the patient.

Do not leave patient alone. Restrain, if necessary. Transport. Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Use of Restraints Limmer et al., Emergency Care Update, 10th Edition

2007 by Pearson Education, Inc. Upper Saddle River, NJ Use of Restraints: Medical-Legal Implications Emotionally disturbed patients may refuse care. To provide care against patients wishes, patient must be harmful to self/others. Continued Limmer et al., Emergency Care Update, 10th Edition

2007 by Pearson Education, Inc. Upper Saddle River, NJ Use of Restraints: Medical-Legal Implications If patient is a threat to self or others, may transport without consent May require medical direction Usually requires law enforcement Limmer et al., Emergency Care Update, 10th Edition

2007 by Pearson Education, Inc. Upper Saddle River, NJ Use of Restraints Have adequate help. Plan ahead. Stay clear of patient until prepared. Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Use of Restraints Once a decision is made, act quickly. Have one EMTB talk patient through process. Secure patient with

approved position/ materials. Secure all 4 limbs. Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Use of Restraints Use reasonable force to prevent patient from injuring self and others.

Avoid force that may injure patient. Continued Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Use of Restraints Reasonable force determined by: Patients size and strength Type of abnormal behavior

Sex of patient Mental state of patient Method of restraint Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Key Term Positional Asphyxia Death of a restrained patient possibly due to respiratory

problems caused by restraint Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Preventing Positional Asphyxia Do not use hog-tie as a hobble restrain. Position patient face-up when possible.

Monitor patient carefully while restrained. Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Use of Restraints Reassess patient frequently. Document incident thoroughly. Indications Methods Witnesses

Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Review Questions 1. List several causes for behavioral change. 2. Describe several verbal and physical methods for assessment of a behavioral emergency.

Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ Review Questions 3. Describe the patient care for behavioral emergencies. 4. List several risk factors for suicide. 5. Describe medical-legal implications for use of restraints. Limmer et al., Emergency Care Update, 10th Edition

2007 by Pearson Education, Inc. Upper Saddle River, NJ STREET SCENES What is your first and most important concern? How should you handle the matter of scene safety? When should you approach the patient? Limmer et al., Emergency Care Update, 10th Edition

2007 by Pearson Education, Inc. Upper Saddle River, NJ STREET SCENES How should the patient be approached? What are the safety concerns when working with an agitated patient? Does this patient need a medical assessment? Limmer et al., Emergency Care Update, 10th Edition

2007 by Pearson Education, Inc. Upper Saddle River, NJ Sample Documentation Limmer et al., Emergency Care Update, 10th Edition 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Recently Viewed Presentations

  • Conjunction Quiz

    Conjunction Quiz

    Arial Calisto MT Default Design Conjunction Quiz 1. How do conjunctions function? 2. What word has letters that represent each of the coordinating conjunctions? 3. Which of the three types of conjunctions is used in pairs? 4. Which type of...
  • Chapter 4

    Chapter 4

    Subjective probability. Uses a probability value based on an educated guess or estimate. Guesses are based on a person's experience and evaluation of a solution. All three types of probability (classical, empirical, subjective) are used to solve a variety of...
  • Alternate Reality Games - Hidden Peanuts

    Alternate Reality Games - Hidden Peanuts

    Arial Times New Roman Wingdings Arial Black Pixel Package Alternate Reality Games The Beast Slide 3 What is an ARG? Example: I Love Bees Example: Last Call Poker Grassroots/Self Sustaining ARGs Vocabulary Tiers of play Real-world crossover Anatomy of a...
  • CFE/CFS GRC Change Summary

    CFE/CFS GRC Change Summary

    New Applications. FCX - File Commander Extended. Capable of taking an command file, command file with embedded delay, or DS file, reading CCSDS packets from said file and sending them over the software message bus with a specified delay between...
  • Add book title here

    Add book title here

    SOURCE: M. Obstfeld and K. Rogoff, Foundations of International Macroeconomics (Cambridge, MA: MIT Press, 1996), Table 7.1. ... New Growth Theory. New growth theory. Modern theories of growth that try to explain the origins of technological progress.
  • Motion - Schoolwires

    Motion - Schoolwires

    Organisms and Their Relationships. Ecology. Organisms depend on other organisms and nonliving factors in their environment for survival. Ecology is the branch of Biology that studies relationships and interactions between organisms and their environment.
  • An Introduction to Shakespeare's

    An Introduction to Shakespeare's

    Mr. William Shakespeare. Born April 23, 1564- died April 23, 1616. Baptismal name: Johanna Shakespeare. Eldest son and third child of John Shakespeare and Mary Arden. Came from Stratford upon Avon-agricultural area. William Shakespeare marries Anne Hathaway in 1582- he...
  • What are Trans Fats? Examples include: Trans fat

    What are Trans Fats? Examples include: Trans fat

    refrigerated dough products. Trans Fat and My Health. Trans fats can have an effect on your health - especially your heart health. If you eat high amounts of trans-fats you are at risk for: Raising your "bad" cholesterol levels. Lower...