Human Behaviour and crisis

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Questions and Answers

What is a common characteristic of skin in elderly individuals?

It is thicker and more elastic.

It bruises easily and is thinner. (correct)

It is less susceptible to tearing.

It heals faster than younger skin.

What is a key feature of Female Genital Mutilation (FGM) Type II?

Removal of the clitoral glans and labia minora. (correct)

Narrowing of the vaginal orifice.

Complete removal of the clitoral glans only.

No removal of any genital tissue.

What might result from children not conforming to societal norms in certain cultures?

They may be considered as possessed by a spirit. (correct)

They are celebrated for their uniqueness.

They are often rewarded.

They receive specialized education.

What does FGM Type IV include?

Any harmful procedure to female genitalia other than those classified in Type I-III. Signup and view all the answers

What potentially harmful behavior occurred in the case involving Eder Guzman-Rodriguez?

He performed an exorcism on his daughter. Signup and view all the answers

What is one risk associated with elderly adults on blood thinners?

They bruise easily. Signup and view all the answers

Which type of FGM involves narrowing the vaginal orifice?

Type III. Signup and view all the answers

Which behavior might be observed in a child believed to be possessed in some cultures?

Being described as a 'wicked girl.' Signup and view all the answers

What effect does high blood glucose levels have on blood vessels?

It irritates the lining of blood vessels. Signup and view all the answers

What is a consequence of the brain shrinking in size with age?

Cognitive decline and memory issues. Signup and view all the answers

Which type of dementia is specifically characterized by amyloid plaques in the brain?

Alzheimer’s Disease. Signup and view all the answers

What physical change is associated with atherosclerosis?

Narrowing of blood vessels. Signup and view all the answers

What type of brain injury is caused by impaired blood flow to certain brain regions?

Cerebrovascular Accident (CVA). Signup and view all the answers

What is the primary role of the 'Romeo' trafficker?

To lure victims with promises of love and a better life. Signup and view all the answers

Which of the following is a common sign of human trafficking?

Significant lack of eye contact, especially females with males. Signup and view all the answers

How do traffickers often control their victims?

Through isolation from friends and family. Signup and view all the answers

What is one method through which victims may be introduced to drugs?

Through forced debt repayment. Signup and view all the answers

What does the term 'Bottom' refer to in the context of human trafficking?

A trusted worker for the trafficker who recruits and controls others. Signup and view all the answers

In which locations is human trafficking most commonly observed?

In large cities and border towns. Signup and view all the answers

What type of tattoos or brands are often associated with victims of trafficking?

Identifiers like barcodes and dollar signs. Signup and view all the answers

Why might victims of human trafficking give scripted responses to professionals?

They are often instructed on what to say. Signup and view all the answers

Under what circumstances is it permissible to restrain a patient?

When directed by a physician or police Signup and view all the answers

What is an appropriate restraint position when securing a patient?

Supine with one arm above head and one at waist level Signup and view all the answers

Which medication is indicated for chemical restraint?

Midazolam Signup and view all the answers

What action should be taken if a patient requires electronic control device probes removal?

Leave them in place unless they pose a risk Signup and view all the answers

How should restraints be secured to the patient's stretcher?

Securely to the body of the stretcher Signup and view all the answers

What is a suitable restraint option for elderly patients?

Less invasive methods like blanket burrito Signup and view all the answers

What type of abuse does not require physical injury to be considered?

Sexual Abuse Signup and view all the answers

Which group is not typically considered most susceptible to abuse?

Young adults in college Signup and view all the answers

What chromosomal defect is characterized by an extra copy of chromosome 21?

Down syndrome Signup and view all the answers

Which symptom is NOT typically associated with Down syndrome?

Short nose Signup and view all the answers

What is a common complication associated with fetal alcohol spectrum disorder?

Learning disabilities Signup and view all the answers

What condition is characterized by poorly controlled voluntary muscles due to developmental brain insults?

Cerebral palsy Signup and view all the answers

How does cystic fibrosis primarily affect the body?

It primarily affects the digestive and respiratory systems. Signup and view all the answers

What is a hallmark sign of bulimia nervosa?

Bingeing followed by purging Signup and view all the answers

Which of the following is a physical sign of anorexia nervosa?

Dry, brittle hair Signup and view all the answers

What psychological characteristic is common in individuals with anorexia nervosa?

Intense fear of weight gain Signup and view all the answers

What can result from hypokalemia as seen in individuals with bulimia nervosa?

Kidney damage Signup and view all the answers

Which symptom is typical of cystic fibrosis related to the respiratory system?

Reduced life expectancy Signup and view all the answers

What is a recognized symptom of cerebral palsy?

Spasticity in limbs Signup and view all the answers

Which disorder includes symptoms like binge eating and compensatory behaviors but maintains normal or above-average body weight?

Bulimia nervosa Signup and view all the answers

What effect can purging have on the body, particularly related to electrolyte levels?

Decrease in sodium levels Signup and view all the answers

What is a common reason behind self-harming behavior?

Experiencing grief or loss Signup and view all the answers

Which of the following best describes non-suicidal self-injury?

Self-inflicted injuries without the intent to die Signup and view all the answers

What is the highest risk factor for a non-suicidal behavior to escalate to a suicidal behavior?

An increase in the severity of the emotional pain Signup and view all the answers

Which statement about suicide risk is accurate?

Suicide attempts by males are often more lethal than those by females Signup and view all the answers

What should be avoided in conversation with someone who is self-harming?

Judging or minimizing their behavior Signup and view all the answers

What is NOT a characteristic of suicidal ideation?

Expressing unhappiness transiently Signup and view all the answers

Which of these methods is commonly associated with successful suicide attempts?

Overdose on medications Signup and view all the answers

What is the primary emotional reason individuals might self-harm?

To express or cope with intense emotional pain Signup and view all the answers

Which demographic has the highest rate of suicides?

Young adults aged 15-34 Signup and view all the answers

What is a misconception about suicidal behavior?

Talking about suicide will encourage it Signup and view all the answers

In discussing suicide, which approach is recommended?

Being direct and open in a private setting Signup and view all the answers

Which of the following is an inappropriate way to respond to self-harming behaviors?

Giving positive feedback to the behavior Signup and view all the answers

What is the primary focus when interacting with someone who self-harms?

Allowing them to express their feelings Signup and view all the answers

At what point do most near-lethal suicide attempts typically occur?

Within 24 hours of a crisis decision Signup and view all the answers

Study Notes

All Human Behavior Slides

The slides cover human behavior, with a focus on mental health, crisis intervention and different types of disorders.
The information presented is about understanding human behaviors and reactions, and how medical professionals (like paramedics) can identify them, the different types of emotional reactions, and various coping mechanisms, and ultimately, how to handle crises and manage/assist individuals dealing with mental health issues (including violence & aggression).
The presentation provides various clinical terms (and definitions) like, sympathy, empathy, compassion, diplomacy, tact and discretion which provide a framework for paramedics/healthcare professionals to operate in situations involving people with mental health issues.
The presentations discusses several mental health related concepts (including mental health, mental health continuum, social determinants of health, crisis management, etc) and how they might manifest in particular populations.

Mental Health

Mental health is defined as a state of psychological, emotional, and social wellbeing.
Key indicators of mental health include the ability to think logically and rationally, choose among thoughts and emotions, match moods to situations, cope with change, stress, and trauma, accept limitations, be productive and achieve potential, and contribute meaningfully to society.
The mental health continuum model shows a spectrum ranging from healthy to ill, highlighting the different emotional reactions a person undergoing a crisis may experience (and the various behaviours a paramedic might observe during an emergency). Several examples for each phase and potential behaviours are included in the slide.

Causes of Mental Illness

Mental illnesses have complex causes involving biological, developmental (childhood experiences), and/or environmental factors.
Biological aspects include genes, brain structure, and brain chemistry and are often linked to illness/injury.
Developmental factors, childhood experiences (particularly adverse childhood experiences), and neurodevelopmental differences play a significant role.
Environmental factors include social issues, poverty, violence, and/or food insecurity.

Maslow's Hierarchy of Needs

Maslow's Hierarchy of Needs illustrates the different levels of human needs, ranging from basic physiological needs (e.g., food, water, warmth, rest) to self-actualization needs (e.g., achieving one's full potential).
People with unmet needs might be at greater risk of mental illness, as their access to higher levels of the hierarchy may be affected.

Social determinants of health involve factors contributing to health, like income, social status, employment/working conditions, education, childhood experiences, physical environments, social supports, coping skills, access to health services, gender, culture, and race.
These elements can significantly affect both physical and mental health, with specific implications for certain social groups. These groups will likely experience increased risk of mental illness based on factors and experiences presented in societal factors.

Crisis Management

A developmental crisis arises from normal life changes such as puberty, leaving home, marriage, childbirth, or retirement.
A situational crisis results from unexpected trauma, loss, or change like death, divorce, critical illness/injury, violence, or property destruction.
A paramedic/healthcare professional needs to understand these types of crises when dealing with a patient so they are prepared to make a correct diagnosis.

Key Terminology

Sympathy involves understanding the feelings of another person without necessarily sharing them.
Empathy means experiencing the same feelings as another person and understanding their situation.
Compassion is feeling concern for another person's suffering and misfortune.
Diplomacy is the art of dealing with people sensitively and effectively.
Tact is using skill and sensitivity in difficult situations.
Discretion is responsible behaviour and speech, avoiding upset/offense, or revealing private information.

Emotions and Emotional Reactions

Slides present a wide range of typical and atypical emotions and reactions, essential for paramedics to recognise and observe for proper management.

Coping Mechanisms

Healthy coping mechanisms include religion, seeking social/professional support, and exercise/meditation.
Unhealthy coping mechanisms include substance abuse, risky behaviours, isolation, overworking, and avoidance/denial. Some possible emotional reactions are described and examples are provided for the slide.

Providing Emotional Support

Providing emotional support through the use of appropriate language, presence, proximity, touch, and sufficient time is vital when dealing with a person in a crisis.

Words Matter

Avoiding stigmatizing language is crucial - using respectful and accurate terms for mental health conditions is critical. There are some examples of better language choices mentioned.

Mood, Personality, and Psychotic Disorders

Slides cover the definitions, manifestations (like daily routines, coping mechanisms, relationships, and perceived realities), and causes of various psychological conditions including neurosis, psychosis, mania, delusions, illusions, hallucination, paranoia, and phobias.

Mood Disorders

Defining (and describing) mood disorders, like major depressive disorder, generalized anxiety disorder and bipolar disorder.

Depression

Symptoms (low mood, lack of pleasure in activities, weight changes, sleep problems, difficulty concentrating) for depression and how to identify in patients (some examples are provided for this slide).

Anxiety

Symptoms (excessive worry and anxiety, restlessness, difficulty sleeping, impaired concentration, irritability, and hypervigilance) for anxiety, and how to appropriately assess in patients. Some examples are included in this slide to help the medical professional to understand the different presentations and reactions in patients.

Bipolar Disorder

Defining bipolar disorder (extreme mood swings and intense emotional states often at the extremes of the emotional spectrum, including ‘highs’/‘lows’) and the possible challenges when dealing with this condition in a medical setting.

Personality Disorders

Slides give descriptions of three clusters of personality disorders (odd and eccentric, dramatic and erratic, fearful and anxious). This section provides types of possible personality and behavioral differences in a patient.

Psychotic Disorders

Defining and describing psychotic disorders (featuring delusions, hallucinations, and other experiences involving a loss of touch with reality). Examples are provided alongside these definitions.

Conversion Disorders

Psychological disorders manifesting as physical symptoms (e.g., paralysis, weakness, loss of sensation, or other physical issues).

Substance Abuse, Violence, & Aggression

Recognizing substance use, violence, and aggression. A discussion on risk factors and possible symptoms amongst different populations exposed to certain risk factors.

Addiction & Substance Misuse

Slides include facts (like young people having a high risk of substance use) about rates of substance abuse, including substance related deaths in Canada. This slide provided facts and statistics.

Addiction

Common elements of addiction like harmful consequences, loss of control, craving, compulsion are discussed here alongside the commonly used four-C’s related to addiction. Also covered are common triggers for addiction, and potential issues involving the brain and different environments.

Clinical Opioid Withdrawal Scale (COWS)

The slide introduces the COWS scale and various medical conditions which this scale/tool is meant to help diagnose and manage. This scale is used to asses, monitor, diagnose, and classify a patient’s condition and management.

Opioid Management

This section provides an overview of treatments for opioid dependence, including medications like Naloxone, Methadone, and Suboxone.

Stimulants

Covered are common stimulants (amphetamine, methyphenidate, cocaine, etc.), uses, common presentations, and methods of use including, injection, snorting, smoking etc.

Sedatives, Hypnotics & Anxiolytics

Identifying common drugs (such as Benzodiazepines, Ketamine, GHB, PCP, Nitrous Oxide). Their methods of usage, and symptoms when used. This includes, signs, symptoms, and potential danger to patients when exposed to these substances.

Hallucinogens

Information on hallucinogens, including common drugs like LSD, Psilocybin, and Ketamine, their methods of use, and potential signs and symptoms when a person might be experiencing use.

Violence & Aggression

Concepts like conflict, assertiveness, aggressiveness, violence, assault, and battery, contrasted with assertive behaviours, and how to manage these conditions. This section includes discussion on the stages of aggression (e.g., triggering event, escalation, plateau, recovery, post-crisis depression) in patients.

Paramedics' role in intervening and giving emergency help without consent, guidelines, and legal considerations when treating incapacitated patients. Legal guidelines and considerations when dealing with unconscious patients.

Physical Restraint

Guidelines on restraining procedures (physical restraints in specific situations), equipment, and roles of different personnel (like police) involved when responding in violent or resisting patient situations.

Chemical Restraint

Medical professionals and their involvement in chemical restraint and administration to address the safety of both the patient and the medical professional.

Electrical Restraint

Procedures and guidelines for employing electrical restraint tools. Specific areas to avoid when applying this type of restraint.

Victims of Abuse

Categories of abuse (child, elder, intimate partner). Different types of abuse (physical, sexual, emotional, neglect, financial), definitions and examples describing the different types. There are a few images, describing the different types.

Physical Abuse (Children)

Descriptions and examples of physical abuse in children, differentiating between accidental and non-accidental injuries and the importance of recognizing risk factors/patterns in children.

Physical Abuse

Physical abuse is defined and described, including various forms of physical injury, and examples are provided. Images are provided to explain different causes of potential injuries.

Physical Abuse: Children

Differentiating accidental from non-accidental injury in children (by age groups - toddlers, preschoolers, early school-aged children).

Physical Abuse: Adults/Elders

Recognizing abuse in older adults/elders, considering differences in their physical abilities and susceptibility for various injuries or illnesses

Sexual Abuse: Children

Identifying different patterns/indications of sexual abuse in children. The different types are mentioned and descriptions alongside examples are illustrated.

Sexual Abuse: Adults

Descriptions of sexual abuse in adults, including diverse types, and contexts where this type of abuse may occur.

Human Trafficking

Understanding human trafficking and the different types that may occur. Examples, warning signs, and other relevant/helpful information.

Psychological Abuse

Identifying and describing various forms of psychological abuse.

Neglect

Recognizing unmet needs including food/water, care of the environment, and other health needs, and inadequate education, supervision, protection against dangers.

Financial Abuse

Identifying signs and descriptions of financial exploitation.

Paramedic Roles and Responsibilities

Defining paramedics roles and responsibilities, including the role of advocacy and the duty to report abuse for both adults and children.

Assessment

Details on assessment methods (including observation of unusual behavior, family members' comments, or other details). This section also has implications on what to do/say/report as appropriate. Examples are included depending on the situation.

History Taking

Specific guidelines on eliciting the correct/important information without bias, being polite/professional, managing/allowing proper consent, and handling disagreements. Specific details are related to eliciting accurate patient/caregiver information.

Therapeutic Approach

Providing a framework for a therapeutic approach. The elements include avoiding assumptions, listening actively, avoiding judgement, respecting privacy, and showing genuine care. Providing a supportive environment/interaction with the patient, rather than trying to fix the patient’s problem/condition immediately.

Escalation

Describing the range of self-harm behaviors (from low to high risk). A framework for understanding how self-harm behaviors might escalate to suicidal behaviors, and the need for distinguishing between different types of intent.

Suicide Continuum

A general framework for understanding the progression from passive death wishes to suicide attempts and death by suicide. This section helps medical professionals/paramedics to better understand the complexities of suicide.

Suicide Plans

Describing different means of suicide, like firearms, knives, hanging, suffocation, poisoning, jumping, vehicular suicide or "suicide by cops". Statistics for both males and females are included

Suicide in Canada: Key Statistics

Data from Canada (e.g., rates of suicide by age, sex, methods, frequency of thoughts/plans/attempts).

Suicide Warning Signs

Understanding typical/common warning signs for suicide (talk, behavior, mood).

Eating Disorders

Different types of eating disorders (including Anorexia nervosa, Bulimia nervosa, Binge Eating Disorder, Avoidant-Restrictive Food Intake Disorder (ARFID), and Pica) and their characteristics, distinguishing symptoms (including physical).

Electrolyte Imbalances

Recognizing the potential electrolyte imbalances associated with eating disorders (including hypokalaemia, hyponatremia, metabolic acidosis, and alkalosis - what to watch/analyse, and the causes).

Diseases and conditions associated with aging (e.g., osteoporosis, hyperkyphosis, osteoarthritis, rheumatoid arthritis, and other degenerative disorders/conditions - both physical and chronic).

Brain Injuries

Different types of brain injuries (e.g., traumatic brain injury [TBI] and cerebrovascular accident [CVA]), their causes, and the possible ramifications.

Changes to Body Tissues

The impacts of aging on different body tissues (skin, brain, bones, joints, and others). Highlighting how aging affects the body, and what issues might arise in the body.

Emergency Treatment & Transport of an Incapable Patient

Legal aspects to consider when dealing with patients who do not have consent, or may be experiencing extreme reactions. Relevant legal considerations, and specific procedures to follow. There are instances of different patient types in need of proper emergency care, including trauma/violence, mental health, chemical restraint, and substance misuse to name a few.

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