Clinical Practice Procedures: Assessment/Mental … the process of conducting a systematic...
Transcript of Clinical Practice Procedures: Assessment/Mental … the process of conducting a systematic...
Clinical Practice Procedures: Assessment/Mental status
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Date March, 2017
Purpose To ensure a consistent procedural approach to undertaking a patient Mental status assessment.
Scope Applies to all QAS clinical staff.
Author Clinical Quality & Patient Safety Unit, QAS
Review date March, 2019
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URL https://ambulance.qld.gov.au/clinical.html
441QUEENSLAND AMBULANCE SERVICE
Mental status
A mental status assessment is the process of conducting a systematic
evaluation of the patient’s thought processes at a particular time. The intention of such an examination is to guide the paramedic in identifying pertinent behavioural manifestations, but not to diagnose a specific condition. The information gained, along with any pertinent history, is useful in completing an Emergency Examination Authority (EEA), if required.[2]
Indications
Contraindications
• Nil in this setting
Complications
• Behavioural abnormalities
• Violent patients
• Refusal of assessment and/or treatment
• Cultural differences in the understandingof mental health
[1]
March, 2017
Figure 3.27
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442QUEENSLAND AMBULANCE SERVICE
Procedure – Mental status
1. Assess the patient appropriately and attemptto ascertain the cause of the presenting signs and symptoms.
2. Exclude and/or manage causes of abnormal behaviour where possible.
3. Attempt to treat the patient only if safe to do so.
4. Using the guide to mental status examination; observe, question and note
relevant information. This must be conducted in a highly respectful and empathic manner.
Judgemental attitudes, interogatory questioning styles or other disrespectful
stances will usually only serve to exacerbate a patient’s condition.
5. Be mindful that different cultures hold different
beliefs about mental illness. For some cultures,
mental health is determined by physical and/or
spiritual influencers. For others, mental illness
is a taboo subject and is not discussed openly.
MENTAL STATUS ASSESSMENT GUIDEMENTAL STATUS ASSESSMENT GUIDEMENTAL STATUS ASSESSMENT GUIDEMENTAL STATUS ASSESSMENT GUIDE
Appearance Thought form
Behaviour Thought content
Speech Perception
Mood Insight & judgement
Affect
• grooming• posture • build• clothing• cleanliness
• eye contact• mannerisms• gait • activity level
• rate • volume • pitch • tone • flow • pressure
Emotion as described:• anxious• depressed• cheerful
Emotion as observed:• restrictive• blunted• labile
• amount • rate • derailment • flight of ideas
• disturbances• delusions • suicidal • obsessions
• illusions• thought insertion• broadcasting• hallucinations
- auditory- olfactory- tactile- visual - gustatory
• cognition • illness • understanding• cause & effect
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