Behavioral Emergencies Chapter 24

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Questions and Answers

Which of the following is a risk factor for suicide?

High self-esteem

Recent loss or bereavement (correct)

Strong familial support

Increased physical activity

What behavior may indicate potential violence in a patient?

Focused eye contact

Excessive emotional outbursts (correct)

Relaxed body language

Calm conversation

What is an effective patient assessment technique during a psychological crisis?

Ignoring the patient's emotional state

Ensuring a calm and quiet environment (correct)

Aggressively questioning the patient

Providing immediate solutions

Which communication strategy is essential in emergencies?

Maintaining a calm and reassuring tone Signup and view all the answers

Which intervention is crucial for ensuring patient safety during a behavioral emergency?

Calming the patient and assessing their needs Signup and view all the answers

Signs of agitation in a patient may include which of the following?

Rapid speaking and movement Signup and view all the answers

What factor can affect a person's behavior during a crisis?

Low blood sugar levels Signup and view all the answers

What type of thinking may suggest a psychological crisis?

Bizarre or irrational thinking Signup and view all the answers

Which intervention should be prioritized when approaching a patient showing signs of a psychological crisis?

Building rapport and trust Signup and view all the answers

Which of the following conditions can potentially lead to abnormal behavior?

Mind-altering substances Signup and view all the answers

Which of the following is considered a risk factor for suicide?

Being widowed or divorced Signup and view all the answers

Which behavior may indicate a potential for violence in a patient?

Yelling and using profanity Signup and view all the answers

What is a critical question to ask when assessing a patient with potential self-destructive behavior?

Do you have suicidal tendencies? Signup and view all the answers

In assessing a patient's safety, which of the following should be noted?

Scene environment and potential hazards Signup and view all the answers

What is an important communication strategy during emergencies with potentially violent individuals?

Maintain a calm and assertive demeanor Signup and view all the answers

Which of the following factors would NOT be considered a risk factor for suicidal behavior?

Strong social support networks Signup and view all the answers

What is indicated by a patient who is sitting on the edge of their seat with clenched fists?

They may be preparing to act out in violence Signup and view all the answers

Which of the following behaviors should an EMT be alert to when assessing for self-destructive tendencies?

Gathering items that could be used for self-harm Signup and view all the answers

Which emotion should be assessed in patients to understand their level of distress?

Fear or anxiety Signup and view all the answers

What is NOT a sign of a behavioral emergency?

Outward expression of happiness Signup and view all the answers

What is one indicator of potential violence in a patient?

Patient has clenched fists or holds lethal objects Signup and view all the answers

Which method is effective in calming a patient during an emergency?

Encourage the patient to express their troubles Signup and view all the answers

What is a key technique in patient assessment?

Assess appearance, activity, speech, and orientation Signup and view all the answers

When should restraints be considered in emergency care?

If the patient is a danger to self or others Signup and view all the answers

What is an appropriate communication strategy with a distressed patient?

Speak in a calm, reassuring voice Signup and view all the answers

Which of the following is a sign that a patient may resist treatment?

Patient threatens EMTs and others Signup and view all the answers

When assessing a patient for a behavioral emergency, what is an important first step?

Identify yourself and explain your intentions Signup and view all the answers

Which action should be taken when physical restraint is necessary?

Have police present and gain approval from medical direction Signup and view all the answers

What indicates that a patient may be experiencing a psychological crisis?

Patient exhibits rapid mood swings and erratic actions Signup and view all the answers

How should documentation of restraint be approached?

Always document the indication for restraint and techniques used Signup and view all the answers

Study Notes

Scenario

A 45-year-old woman, recently widowed, hasn't been seen by neighbors for three days.
Neighbors reported the woman as being very depressed.
Police and EMS were called to check on her.
The woman's demeanor was observed as problematic.

Patient

A slide displayed an image of the patient.

What Will You Do?

This is a question posed.

Chapter 24: Behavioral Emergencies

This is part of a chapter on the subject.

Overview

Behavior: Behavior is how a person acts or performs, encompassing all physical and mental activities. Many factors influence behavior, including culture, stress, and psychology.
Behavioral Emergency: A behavioral emergency arises when abnormal behavior poses potential harm to the individual or others, or is deemed unacceptable by the person, family, or community.
Conditions Affecting Behavior: These include low blood sugar, lack of oxygen, inadequate blood flow to the brain, head trauma, excessive heat or cold, and mind-altering substances.
Psychological Crises: This may include panic, agitation, bizarre thinking, paranoia (believing someone is plotting against you), mania (agitated and rapid speech/movement), depression (unwilling to engage or move), self-destructive behavior (like suicide), and threats or violence to others.
Suicidal Gestures: Thoughts of death or taking one's life are considered a suicidal gesture. EMT-Basics must recognize and intervene in self-destructive behavior before the act of suicide.

Risk Factors for Suicidal Gestures

Individuals over 40.
Single, widowed or divorced individuals.
Alcoholics.
Depressed individuals.
Individuals with a defined, lethal plan of action, verbalized.
Unusual gathering of items capable of causing death.
Previous history of self-destructive behavior.
Recent diagnosis of serious illness.
Recent loss of a significant loved one.
Arrest or imprisonment.
Loss of job.
Previous episodes of self-harming acts.
Previous history of severe or repeated psychological issues.

Review Questions

Define behavior: Behavior is how a person acts or performs, encompassing all their physical and mental actions.
Risk factors for suicide: Previous destructive behavior and being recently widowed are considered risk factors.

Assessment and Emergency Care

Scene Size-Up: Assess the patient's environment for safety, including if they are holding unsafe objects. Assess for self-destructive behavior during the initial assessment.
Signs of Potential Violence: Signs include sitting on the edge of a seat, clenched fists, yelling or using profanity, moving or standing towards an EMT, throwing things, holding a potentially dangerous object, and unusual behavior making the EMT uneasy or uncomfortable.
Focused History and Physical Exam: Determine how the patient feels, assess for suicidal tendencies, if they are a threat to themselves or others, if a medical issue is present, and if prior interventions have been attempted.
Assessment of Potential Violence: Check with family or bystanders to find out if the patient has a history of aggression or combativeness. Note the patient's posture and if they are in a position threatening themselves or others, note use of aggression or combativeness (clenched fists, objects), vocalizations indicative of intent to harm. Assess the patient's physical activities, and observe if they are moving towards caregiver and carrying heavy or threatening objects. Muscles should be noted.

Communication and Emergency Care

Scene Size-up, Personal Safety: Prioritize the scene's safety for yourself.
Patient Assessment: Evaluate the patient.
Calm the Patient: Calm the patient without judgment.
Do Not Leave Alone: Do not leave the patient alone.
Restraints: Restraint should be used cautiously if the patient is a risk to themselves or others. Always have law enforcement present if possible.
Consider Need for Law Enforcement: Determine if law enforcement is required or needed.
Principles for Assessing Behavioral Emergency Patients: Principles include identifying yourself, informing the patient what you're doing, employing a calm, reassuring voice, allowing the patient to speak without being judged, showing you understand them through rephrasing or echoing, and acknowledging the patient's feelings.
Assessing Mental Status: Evaluate the patient's appearance, activity, speech, and orientation regarding time, place and person.
Overdose: If an overdose, retrieve any medications or drugs.

Calming the Patient

Maintain a comfortable distance from the patient.
Encourage the patient to articulate their concerns.
Respond honestly to the patient's questions.
Do not threaten, challenge, or argue with troubled patients.
Tell the truth; do not lie to the patient.
Do not "play along" with visual or auditory disturbances of the patient.
Include trusted family members or friends, if appropriate.
Be prepared to remain on site for an extended period of time.
Avoid unnecessary physical contact; call additional help if needed.

Restraints

Restraints should only be used if the patient is a danger to themselves or others. Police presence, when possible, and medical approval are required.
Techniques involve using only necessary force, estimating the patient's range of motion, planning actions, and acting quickly.
Approach with appropriate staff, assigning one staff member to each limb.
Secure limbs together using approved medical equipment.
Secure the patient to a stretcher with multiple straps.

Medicolegal Considerations

Consent: Determine if the patient is capable of making decisions; if so, obtain their consent.
Resistance to Treatment: Disturbed patients frequently resist treatment and may threaten EMTs and bystanders.
Providing Care Against Will: Justification is required to provide care without consent. If the patient poses a threat to self or others, contact medical direction after assessing and before using force.
Law Enforcement: Law enforcement is generally involved in situations where care must be provided against the patient's will.

Summary

Behavior, Changes, Crises, and Gestures: Covers behavior changes (or crises), suicidal gestures.
Assessment/Emergency Care: This section discusses assessment and care including scene size-up, communication with patient, calming, and restraints.
Medical/Legal Considerations: Consent, resistance to treatment, use of force and documentation fall in this section.

Studying That Suits You

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Description

Explore the complexities of behavioral emergencies with this quiz based on Chapter 24. Learn how factors such as stress, culture, and psychological conditions can influence behavior, especially in crisis situations. Assess your understanding of the appropriate responses in scenarios involving potentially harmful behaviors.