Behavioral Emergencies CHAPTER 23. BehaviorBehavior.

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Behavioral Behavioral Emergencies Emergencies CHAPTER 23 CHAPTER 23
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Transcript of Behavioral Emergencies CHAPTER 23. BehaviorBehavior.

  • Slide 1
  • Behavioral Emergencies CHAPTER 23
  • Slide 2
  • BehaviorBehavior
  • Slide 3
  • Behavioral emergency: Abnormal behavior in a situation that results in potential harm to oneself or others. Behavior that is unacceptable or intolerable to self, family members or community.
  • Slide 4
  • Behavioral Changes
  • Slide 5
  • Conditions that Alter Behavior Situational stresses Medical illnesses Illegal and legal drugs/alcohol Diabetics with low blood sugar Hypoxia and poor cerebral blood flow Excessive heat or cold Head injury
  • Slide 6
  • Alcohol can produce obvious changes in behavior.
  • Slide 7
  • Geriatric patients may be at more risk for behavioral emergencies.
  • Slide 8
  • Organic brain syndrome: A condition caused by a disturbance of physiologic functioning of brain tissue. More common in elderly patients.
  • Slide 9
  • Psychological Crises
  • Slide 10
  • Psychotic: Refers to behavior by a person who has lost touch with reality. Mental illness may produce psychotic thinking.
  • Slide 11
  • Types of Psychoses Paranoia May be unreasonably afraid of malicious intentions or acts of others Mania May be very agitated, moving and speaking rapidly without producing clear or complete sentences Depression May not want to move or answer questions
  • Slide 12
  • Types of Psychoses continued Phobia Acute anxiety Disorientation Disorganization
  • Slide 13
  • Suicidal Gestures
  • Slide 14
  • Risk Factors of Suicide Patient more than 40 years of age, widowed or divorced, alcoholic or depressed Patient who has talked about taking their own life Patient with a previous history of self-destructive behavior Patient with a recently diagnosed serious illness
  • Slide 15
  • Risk Factors of Suicide continued Patient in an environment where there is an unusual gathering of destructive articles (e.g., guns or many pills) Patient who has recently lost a loved one Patient who has recently been arrested or imprisoned Patient who has recently lost a job
  • Slide 16
  • Suicide can be devastating for the family and friends of the victim.
  • Slide 17
  • Assessment and Emergency Care Scene Size-up
  • Slide 18
  • If the scene is unsafe, stay out and... contact law enforcement.
  • Slide 19
  • Signs of Potential Violence Sitting on edge of seat, as if ready to move Clenched fists Yelling and using profanity Standing or moving toward EMT Throwing things Holding a potentially dangerous object Any behavior that makes the EMT uneasy
  • Slide 20
  • Never allow participants in a dispute to get between you and the exit route.
  • Slide 21
  • If you feel the situation may get out of control, call for assistance.
  • Slide 22
  • Obtain information from bystanders about the patients behavior prior to EMS arrival.
  • Slide 23
  • Domestic disputes often erupt in violence.
  • Slide 24
  • Caution: Any object near the patient can be dangerous!
  • Slide 25
  • Communication and Emergency Medical Care
  • Slide 26
  • Assess how the patient actually feels, and determine if they are exhibiting suicidal tendencies.
  • Slide 27
  • Questions to Ask the Patient What is your name, the date, your address? How do you feel? Would you like some help with your problem? Do you have a history of heart disease, diabetes, etc.?
  • Slide 28
  • Observe the patients: Appearance Activity Speech Orientation to time, person and place
  • Slide 29
  • If you suspect spouse or child abuse, contact law enforcement. Document any abuse observed, or reasons for suspecting abuse.
  • Slide 30
  • Calming the Patient
  • Slide 31
  • Keeping the Patient Calm Ask questions in a calm and reassuring manner Do not be judgmental Repeat the patients answers to show you are listening Remain a comfortable distance away Use good eye contact Dont make sudden movements
  • Slide 32
  • RestraintsRestraints
  • Slide 33
  • Follow local protocols and laws regarding restraints. Document patients condition before and after applying restraints.
  • Slide 34
  • Restraining a Patient Have adequate help, including law enforcement Have a plan of action Use only necessary force Stay beyond patients range of motion Act quickly Talk to the patient Work with other EMS personnel, deciding in advance how each will restrain a limb, and approach together
  • Slide 35
  • Restraining a Patient continued Secure limbs with approved equipment It may be necessary to turn patient face down on stretcher The patients face may be covered with a surgical or O 2 mask if they are spitting or biting Reassess the situation frequently, including vitals and physical status Document your and the patients actions
  • Slide 36
  • Soft Restraint
  • Slide 37
  • A patient with leather restraints.
  • Slide 38
  • Restraining a Patient Approach from behind, pull arms back, and bend at waist.
  • Slide 39
  • Restraining a Patient continued The patient may be placed prone with restraints.
  • Slide 40
  • Restraining a Patient continued The patient may be placed supine with restraints.
  • Slide 41
  • Medical and Legal Considerations Consent
  • Slide 42
  • If an emotionally disturbed patient consents to treatment and transport, decisions are more easily made, and legal problems possibly avoided.
  • Slide 43
  • Resistance to Treatment
  • Slide 44
  • You may need to decide if a patient is mentally able to make an informed decision. Follow local protocols regarding patients who refuse treatment.
  • Slide 45
  • If you are unsure of the mental capabilities of the patient, you should treat and transport.
  • Slide 46
  • Use of Force
  • Slide 47
  • Use only enough force to keep patients from injuring themselves or others. Avoid physical force that may cause harm to the patient.
  • Slide 48
  • Reasonable force depends upon: Patients size and strength Type of abnormal behavior exhibited by patient Gender of patient Mental status of patient Method of restraint used
  • Slide 49
  • DocumentationDocumentation
  • Slide 50
  • Behavioral Documentation Position in which patient was found Aggressive or abnormal action produced by patient Anything unusual the patient says All aspects of assessment and findings (in detail) Restraining procedures used Names of persons assisting or witnessing treatment and transport
  • Slide 51
  • SUMMARY Behavior Behavior Assessment and Emergency Care Assessment and Emergency Care Medical and Legal Considerations Medical and Legal Considerations