BEHAVIORAL EMERGENCIES

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LESSON 13. BEHAVIORAL EMERGENCIES. Behavioral Emergencies. Process of giving emergency care may be complicated by patient’s behavior Many injuries and medical emergencies may cause altered mental status or emotional responses Patients may have emotional problems - PowerPoint PPT Presentation

Transcript of BEHAVIORAL EMERGENCIES

Slide 1Behavioral Emergencies
Process of giving emergency care may be complicated by patient’s behavior
Many injuries and medical emergencies may cause altered mental status or emotional responses
Patients may have emotional problems
Patient may be a danger to self or others
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Low blood sugar
Head trauma
Appearance
Actions
Speech
Mood, thought processes
Behavior May Occur
Person holding weapon or something that can be used as weapon
Person in threatening posture
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Person known to be violent
Hallucinations, paranoia
Signs Violent
Self-destructive behavior or suicide attempts represent danger to the patient
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How does the patient feel?
Is the patient thinking about hurting or killing himself or herself or others?
Does the patient have cultural or religious beliefs consistent with suicide or violence?
Does the patient have a medical problem or trauma?
Might the patient have a weapon?
Is it safe to attempt an intervention?
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Impulsive or aggressive tendencies
Taking risks that could cause death
Loss of interest in past activities
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Give medications or drugs to arriving EMS
Don’t assume patient is drug impaired
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Always try to talk patient into cooperation
Call for additional help if needed, including law enforcement if appropriate
Avoid restraints unless necessary
Calm and reassure patient
Ask patient for name, and use it
Tell patient what you plan to do
Treat patient with respect
In cultures where acceptable, make eye contact
Encourage patient to tell you what happened and what troubles him or her
Show you care
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Do not make quick moves
Respond honestly to questions
Don’t “play along” with hallucinations
Involve family members or friends
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Calming a Behavioral Patient (continued)
Be patient, and be prepared to stay at scene for a long time
Always remain with patient
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Victims of Abuse
and Sexual Assault
Child abuse, spouse abuse (domestic violence), elder abuse and sexual assault often cause injuries treated by EMRs
These situations may also be behavioral emergencies
Be sensitive to situation while providing medical care
Report your observations to responding EMS personnel and in your run report
Take special crime scene considerations
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Victim stays with abusing spouse or partner
Signs of potential domestic violence:
Patient seems unusually fearful
Patient’s spouse or partner aggressively blames patient
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Ensure privacy for patient
Tell responding EMS personnel in private about your suspicions
Do not directly confront patient with suspicions, especially if spouse or partner is present
Do not confront patient’s spouse or partner
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Follow local protocol to report suspected cases to appropriate authorities
If patient communicates information to you suggesting abuse, report this to responding EMS personnel and document it
If appropriate, call for law enforcement personnel
If necessary, withdraw from scene to ensure your safety
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Victim of sexual assault or rape may have other injuries
Patient may or may not say what happened
Be aware of likely psychological trauma
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Be sensitive to patient’s psychological trauma
Patient may be hysterical, crying, hyperventilating or in a dazed, unresponsive state
Provide emotional support
Rape requires law enforcement personnel
Ensure privacy for patient
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Ensure patient is not left alone
Provide medical care as needed for any injury
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Most EMRs do not restrain patients
Restrain only if you have been trained and it is part of local protocol
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Restraining Patients (continued)
Avoid unreasonable force
Use only as much force as needed to keep patient from injuring him or herself or others
Use reasonable force to defend yourself
Avoid acts or physical force that may injure patient
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Patient’s abnormal behavior
Patient’s mental state
local protocol
Plan approach you will use – then act quickly
One responder should talk to patient throughout process
Four responders approach together, 1 assigned to
each extremity
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© 2011 National Safety Council
Guidelines for Restraining (continued)
Do not restrain patient face down; maintain airway access at all times
Assess patient’s breathing and circulation frequently
Provide oxygen by non-rebreather mask if appropriate
Once a patient is restrained, do not remove restraints
Document indications and technique used
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Document abnormal behavior factually
When possible, have same-sex responders provide care
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Get patient’s consent, witnessed by others
If patient threatens self-harm or you believe this may occur, follow local protocol to provide care against patient's will if safe to do so
Assistance of law enforcement usually required
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