Podcast
Questions and Answers
A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred, and she is not alert to her surroundings. You should:
A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred, and she is not alert to her surroundings. You should:
- Allow the patient to refuse transport if she wishes.
- Transport the patient to a psychiatric facility.
- Inquire about the possibility of head trauma. (correct)
- Conclude that the patient's blood sugar is high.
Which of the following conditions or situations would MOST likely make excited delirium worse?
Which of the following conditions or situations would MOST likely make excited delirium worse?
- Limited physical contact
- Elevated blood glucose
- Alcohol withdrawal (correct)
- Dimly lit environment
In which position should you restrain a physically uncooperative patient?
In which position should you restrain a physically uncooperative patient?
- With arms and legs bound together
- Prone
- Supine (correct)
- With hands tied behind the back
You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:
You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:
Signs of excited delirium include:
Signs of excited delirium include:
When caring for a patient experiencing excited delirium, the EMT should remember that:
When caring for a patient experiencing excited delirium, the EMT should remember that:
Organic brain syndrome is defined as:
Organic brain syndrome is defined as:
A patient with a history of schizophrenia called EMS because he was experiencing abdominal pain. When law enforcement arrived, the patient became violent, necessitating the placement of handcuffs. When you assess the patient, he tells you that killing someone will make his abdominal pain go away. His vital signs are stable. How should you manage this situation?
A patient with a history of schizophrenia called EMS because he was experiencing abdominal pain. When law enforcement arrived, the patient became violent, necessitating the placement of handcuffs. When you assess the patient, he tells you that killing someone will make his abdominal pain go away. His vital signs are stable. How should you manage this situation?
A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said, is called:
A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said, is called:
Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct?
Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct?
The term 'behavioral crisis' is MOST accurately defined as:
The term 'behavioral crisis' is MOST accurately defined as:
The single most significant factor that contributes to suicide is:
The single most significant factor that contributes to suicide is:
General guidelines for managing a patient with a behavioral emergency include:
General guidelines for managing a patient with a behavioral emergency include:
Posttraumatic stress disorder can happen after:
Posttraumatic stress disorder can happen after:
____________ is what you can see of a person's response to the environment.
____________ is what you can see of a person's response to the environment.
You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence?
You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence?
A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:
A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:
You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?
You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?
A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:
A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:
In contrast to a behavioral crisis, a behavioral health emergency occurs when a person:
In contrast to a behavioral crisis, a behavioral health emergency occurs when a person:
Immediately after physically restraining a violent patient, the EMT should:
Immediately after physically restraining a violent patient, the EMT should:
Law enforcement personnel request your assistance for a 30-year-old man who was pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:
Law enforcement personnel request your assistance for a 30-year-old man who was pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:
Common causes of acute psychotic behavior include all of the following, EXCEPT:
Common causes of acute psychotic behavior include all of the following, EXCEPT:
You may not be able to determine whether a person has a mental illness, but you can predict the person's likelihood of becoming:
You may not be able to determine whether a person has a mental illness, but you can predict the person's likelihood of becoming:
Which of the following is an example of a functional behavioral disorder?
Which of the following is an example of a functional behavioral disorder?
When assessing a patient who is displaying bizarre behavior, the EMT should:
When assessing a patient who is displaying bizarre behavior, the EMT should:
You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system?
You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system?
After ensuring his or her own safety, the EMT's next priority when caring for a patient with a behavioral emergency is to:
After ensuring his or her own safety, the EMT's next priority when caring for a patient with a behavioral emergency is to:
The first step in assessing a patient with a behavioral emergency is to:
The first step in assessing a patient with a behavioral emergency is to:
A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious and has a patent airway and adequate breathing. You should:
A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious and has a patent airway and adequate breathing. You should:
People at risk for suicide include all of the following, EXCEPT:
People at risk for suicide include all of the following, EXCEPT:
A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:
A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:
A physiologic disorder that impairs bodily function when the body seems to be structurally normal is called a:
A physiologic disorder that impairs bodily function when the body seems to be structurally normal is called a:
It is MOST important for the EMT to remember that suicidal patients may:
It is MOST important for the EMT to remember that suicidal patients may:
When assessing a patient with a behavioral crisis, you should:
When assessing a patient with a behavioral crisis, you should:
A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred, and she is not alert to her surroundings. You should:
A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred, and she is not alert to her surroundings. You should:
General guidelines for managing a patient with a behavioral emergency include:
General guidelines for managing a patient with a behavioral emergency include:
You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?
You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?
Organic brain syndrome is defined as:
Organic brain syndrome is defined as:
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Study Notes
Behavioral Health Emergencies Overview
- Acute changes in behavior can indicate serious medical conditions; always assess for physical causes.
- Patients with a history of diabetes or cognitive disorders like Alzheimer's should be closely monitored for potential fluctuations in mental status.
Excited Delirium
- Worsened by alcohol withdrawal; critical to assess and treat conditions causing agitation.
- Signs include diaphoresis (sweating), tachycardia (rapid heart rate), and hallucinations.
- EMTs must be aware that sudden death may occur if violent behavior is not controlled.
Restraint and Patient Positioning
- A physically uncooperative patient should be restrained in the supine position for safety.
- Always reassess the patient’s airway and breathing immediately after restraining.
Domestic Situations and Safety
- In cases of domestic disputes with potential weapon presence, remain in a safe location while notifying law enforcement.
- Approach patients with caution, especially those exhibiting violent or agitated behavior.
Evaluation of Behavioral Crises
- Use reflective listening techniques to assess patient thoughts and state intentions clearly.
- The first step in assessing behavioral emergencies is ensuring the EMT's own safety.
- Consider acute medical conditions as a cause of bizarre behaviors during evaluation.
Mental Health Conditions and Risks
- Most significant suicide risk factors include depression, previous suicide attempts, and chronic illnesses.
- Schizophrenia is categorized as a functional behavioral disorder impacting thinking and behavior.
- Patients may demonstrate violent behavior, regardless of established mental health history.
Management of Suicidal Patients
- Inquire directly about suicidal plans during assessment to gauge severity and risk.
- Exercise caution when managing suicidal patients, as they may also pose threats to others.
Legal and Ethical Considerations
- When caring for individuals with violent behaviors, protection for all parties, including law enforcement, is crucial.
- Always document findings and interactions carefully, especially in crisis situations.
Guidelines for Interaction
- Spending extra time and providing reassurance can help manage anxious and agitated patients.
- Maintain awareness of verbal and non-verbal communication cues to assess emotional states.
Summary of Common Behavioral Health Emergencies
- Organic brain syndrome is characterized by brain dysfunction from physical or physiological causes.
- Recognize that behavioral crises may stem from a variety of underlying issues, necessitating a comprehensive assessment approach.
Training and Preparedness
- EMTs should be prepared to handle various behavioral emergencies and should reinforce skills in crisis management, restraint, and communication strategies.
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