LESSON 21 BEHAVIORAL EMERGENCIES - websites.rcc.edu

© 2011 National Safety Council

BEHAVIORAL EMERGENCIES

LESSON 21

21-1


Behavioral Emergencies

• Process of giving first aid may be complicated by

victim’s behavior

• Many injuries or illnesses can cause altered mental

status or emotional responses

• Victims may have emotional problems

• Abuse and rape are behavioral situations

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Emotional and Behavioral Responses

to Injury and Illness

• Normal reactions include fear, anxiety and apprehensiveness

• Normal reactions may cause trembling, shakiness, nausea, fast heartbeat and breathing, perspiration

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• Do not judge victim’s behavior too quickly – assess

the situation

• If it is unsafe, call 9-1-1 and stay at a safe distance

until help arrives

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Emotional and Behavioral Responses

to Injury and Illness continued


Altered Mental Status

• Results from many different injuries and illnesses

- Lowered levels of responsiveness may result from low

oxygen levels

• Victim may feel dizzy, drowsy, disoriented or

confused

• First aid is often treating underlying cause

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Causes of Altered Mental Status

• Respiratory

emergencies

• Cardiac emergencies

• Poisoning

• Head injuries

• Seizures

• Diabetic emergencies

• Stroke

• High fever

• Substance abuse

• Drug overdose

• Heat or cold

emergencies

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Reassuring and Calming Victims

• Tell victim who you are

• Say you are there to help

• Avoid seeming judgmental

• Do not assume victim is intoxicated or on drugs

• Reassure victim that help is on the way

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• Speak in a caring, reassuring voice

• Do not give false reassurances or lie about victim’s

condition

• Do not argue

• Show you understand by repeating or rephrasing

what victim says

• Do not challenge irrational or delusional statements

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Reassuring and Calming Victims continued


• Stay a safe distance until victim accepts your help

- Do not attempt to restrain or force care

- Withdraw if scene not safe

• Tell victim what you plan to do before doing it

• Move calmly and slowly

• Touch victim only as necessary

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Reassuring and Calming Victims continued


Actions For Victim With Anxiety

• Remain calm and patient

• Follow guidelines for calming and reassuring victim

- Often panic will subside in few minutes

• Victim may need more time to calm down and may suddenly experience renewed anxiety

• Be empathetic and gentle

• Allow victims to talk about their feelings

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Common Signs and Symptoms of

Depression

Signs and symptoms:

• Frequent feelings of sadness

• Loss of energy

• Feelings of hopelessness or worthlessness

• Difficulty concentrating

• Difficulty making decisions

• Physical symptoms (abdominal pain, insomnia, appetite loss, recurrent headaches)

• Thoughts of death or suicide

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Actions for a Victim With Depression

• Encourage victim to talk

• Acknowledge that person seems sad and ask why

• Show victim you care

• Help make person comfortable

• Allow person to cry and work through emotion

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• Listen sympathetically to complaints but do not offer

false reassurances

• Talk about available resources

• Be alert to possibility of suicide

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Actions for a Victim With Depression continued


Suicide

• Over 33,000 people commit suicide each year

• Third leading cause of death among those 15-24 years old

• 11th leading cause of death for persons ages 10 and older

• Drug overdose and firearms most common methods

• Most victims talk about committing suicide

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Suicide Warning Signs

• Talking about suicide

• Comments about hopelessness or worthlessness

• Taking risks that could cause death

• Loss of interest in past activities

• Suddenly and unexpectedly seeming calm or happy

after being sad

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Actions for Person Who May be

Suicidal

• Take person seriously

• Listen to what he or she is saying

• Ask what person is planning to do

• Talk calmly and be supportive

• Do not argue with person

• Tell person you understand and care

- Do not give false reassurances

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• Call 9-1-1 if appropriate

• Involve friends or family members

• Do not leave person alone (unless your own safety is

threatened)

• Remove any weapons, drugs or medications

• Don’t let person drive

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Suicidal continued


• If person has firearm or is threatening violence

- Call 9-1-1

- Do not try to restrain the person

- Withdraw if situation becomes violent

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Suicidal continued


Actions For Person Who May

Become Violent

• Do not enter unsafe scene

• Call 9-1-1

• Do not attempt to restrain person

• Monitor situation from safe distance and wait for help

to arrive

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Abuse

• Intentional inflicting of injury or pain on someone under abuser’s power

• Victims include children, spouses, elderly parents

• Be sensitive to victim’s emotional status

• Be aware of special issues to handle situation

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Signs of Physical Abuse: Child

• Unexplained scalding or burns, rope burns,

lacerations, bites, bruises, broken bones

• Fading bruises or marks after absence from school or

childcare

• Seems frightened of parents and scared to go home

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Signs of Physical Abuse: Child continued

• Shrinks at approach of adult

• Reports being injured by someone

• Appears withdrawn, depressed, cries often

• Aggressive, disruptive

• Seems tired

• Complains of frequent nightmares

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Sexual Abuse

• Includes fondling child’s genitals, penetration, incest,

rape, sodomy, indecent exposure or exploitation

through prostitution or pornography

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Signs of Sexual Abuse: Child

• Difficulty walking or sitting

• Suddenly refuses to change clothes

• Reports nightmares or bed-wetting

• Sudden change in appetite

• Bizarre, sophisticated or unusual sexual knowledge

or behavior

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Signs of Sexual Abuse: Caregiver

• Unduly protective of child

• Severely limits child’s contact with other children

• Secretive and isolated

• Jealous or controlling with family members

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Reporting Child Abuse

• If you suspect abuse or neglect, report it to authorities

- Police

- Child protective services

• Your report will help protect child and get help for family

• Your report is confidential and may be anonymous

• You may be legally required to report it

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Care For Apparently Abused Child

• Do not confront parents

• Do not ask direct questions about abuse

• Provide first aid as usual

• Follow guidelines for documentation

- If child tells you injury caused by caregiver or other adult,

include this in report

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Signs of Domestic Violence

• Victim unusually fearful

• Victim’s account of injury inconsistent or unlikely

• Victim uneasy in presence of partner

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Guidelines for Suspected Domestic

Violence Situations

• Provide first aid as usual

• Call 9-1-1 for significant injuries and report any

suspicions

• Ensure privacy when providing care

• Do not directly confront victim with suspicions

• Try to involve friend or family member

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Guidelines for Suspected Domestic

Violence Situations continued

• You may be required to report suspected abuse

• If victim communicates abuse to you, you can tell

victim domestic violence is against the law and help is

available

• If you see physical abuse occurring or the threat of

violence, call 9-1-1 and stay away

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Elder Abuse

• Physical, emotional or financial abuse or neglect

inflicted on someone over age 60

- Affects more than 500,000 in United States each year

- 90% of cases, abuser is family member

- The older the person, the greater the risk

- The more person needs help with daily activities, the greater

the risk

- Abuse more likely to result in injury

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Signs and Symptoms of

Elder Emotional/Psychological Abuse

• Emotional upset or agitation

• Extreme withdrawal, lack of communication and

responsiveness

• Report of verbal or emotional abuse

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Signs and Symptoms of

Elder Neglect

• Dehydration, malnutrition, untreated bedsores, poor

personal hygiene

• Untreated health problems

• Unsafe living conditions

• Unsanitary living conditions

• Report of neglect

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Care For Victim of Elder Abuse

• All states have specific elder abuse laws

• Report suspected abuse to adult protective service agency

- Information is confidential

- State agency will investigate and provide services

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Sexual Assault and Rape

• Rape = forced sexual intercourse (both psychological

coercion and physical force)

• Sexual assault = completed or attempted attacks of

unwanted sexual contact (may or may not involve

force)

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Sexual Assault and Rape Statistics

• 1 of every 6 women is victim of attempted or completed rape in her lifetime.

• 17.7 million American women have been victims of attempted or completed rape.

• 2.78 million American men have been victims of sexual assault or rape.

• 9 of every 10 rape victims are female.

• 15% of sexual assault and rape victims are under age 12. 80% are under age 30.

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Care For Victim of Rape or Sexual

Assault

• Be sensitive to psychological trauma

• Call 9-1-1

• Ensure privacy for victim

• Try to involve friend or family member

• First aider of same sex may be better

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• Provide first aid as needed, stay with victim till help

arrives

• Preserve evidence

- Ask victim not to urinate, bathe or wash any area

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Care For Victim of Rape or Sexual

Assault continued


Follow-Up Care

• Rape victims usually have full physical examination

• Possible later testing for STDs and pregnancy

• Counseling by rape crisis centers or support groups

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LESSON 21 BEHAVIORAL EMERGENCIES - websites.rcc.edu

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