EMT Chapter 23 Behavioral Health Emergencies
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EMT Chapter 23 Behavioral Health Emergencies

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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?

  • Limited physical contact
  • Elevated blood glucose
  • Alcohol withdrawal (correct)
  • Dimly lit environment

    • 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:

    <p>Remain in a safe place and request law enforcement.</p> Signup and view all the answers

    Signs of excited delirium include:

    <p>Diaphoresis, tachycardia, and hallucinations.</p> Signup and view all the answers

    When caring for a patient experiencing excited delirium, the EMT should remember that:

    <p>Sudden death can occur if the patient's violence is not controlled.</p> Signup and view all the answers

    Organic brain syndrome is defined as:

    <p>A dysfunction of the brain caused by abnormal physical or physiological function.</p> Signup and view all the answers

    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?

    <p>Request a police officer to accompany you in the ambulance.</p> Signup and view all the answers

    A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said, is called:

    <p>Reflective listening.</p> Signup and view all the answers

    Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct?

    <p>Although the physical exam can be difficult, the patient's emotional state may be determined by noting facial expressions, pulse rate, and respirations.</p> Signup and view all the answers

    The term 'behavioral crisis' is MOST accurately defined as:

    <p>A situation in which a patient of any age exhibits agitated, violent, or uncooperative behavior.</p> Signup and view all the answers

    The single most significant factor that contributes to suicide is:

    <p>Depression.</p> Signup and view all the answers

    General guidelines for managing a patient with a behavioral emergency include:

    <p>Being prepared to spend extra time with the patient.</p> Signup and view all the answers

    Posttraumatic stress disorder can happen after:

    <p>Exposure to or injury from a traumatic occurrence.</p> Signup and view all the answers

    ____________ is what you can see of a person's response to the environment.

    <p>Behavior</p> Signup and view all the answers

    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?

    <p>His large body size</p> Signup and view all the answers

    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:

    <p>Calmly identify yourself to the patient.</p> Signup and view all the answers

    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?

    <p>Ask the patient if she has developed a suicidal plan.</p> Signup and view all the answers

    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:

    <p>Restrain the patient with appropriate force in order to treat his injuries.</p> Signup and view all the answers

    In contrast to a behavioral crisis, a behavioral health emergency occurs when a person:

    <p>Becomes agitated or violent and is a threat to him- or herself or others.</p> Signup and view all the answers

    Immediately after physically restraining a violent patient, the EMT should:

    <p>Reassess the patient's airway and breathing.</p> Signup and view all the answers

    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:

    <p>Limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.</p> Signup and view all the answers

    Common causes of acute psychotic behavior include all of the following, EXCEPT:

    <p>Alzheimer's disease.</p> Signup and view all the answers

    You may not be able to determine whether a person has a mental illness, but you can predict the person's likelihood of becoming:

    <p>Violent.</p> Signup and view all the answers

    Which of the following is an example of a functional behavioral disorder?

    <p>Schizophrenia</p> Signup and view all the answers

    When assessing a patient who is displaying bizarre behavior, the EMT should:

    <p>Consider that an acute medical illness may be causing the patient's behavior.</p> Signup and view all the answers

    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?

    <p>Rapid eye movement</p> Signup and view all the answers

    After ensuring his or her own safety, the EMT's next priority when caring for a patient with a behavioral emergency is to:

    <p>Assess the patient's response to his or her environment.</p> Signup and view all the answers

    The first step in assessing a patient with a behavioral emergency is to:

    <p>Ensure your safety.</p> Signup and view all the answers

    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:

    <p>Ask the daughter how her father normally behaves.</p> Signup and view all the answers

    People at risk for suicide include all of the following, EXCEPT:

    <p>Married males older than 30 years.</p> Signup and view all the answers

    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:

    <p>Open the patient's airway and assess his respirations.</p> Signup and view all the answers

    A physiologic disorder that impairs bodily function when the body seems to be structurally normal is called a:

    <p>Functional disorder</p> Signup and view all the answers

    It is MOST important for the EMT to remember that suicidal patients may:

    <p>Be homicidal as well.</p> Signup and view all the answers

    When assessing a patient with a behavioral crisis, you should:

    <p>Be direct and clearly state your intentions.</p> Signup and view all the 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:

    <p>Inquire about the possibility of head trauma</p> Signup and view all the answers

    General guidelines for managing a patient with a behavioral emergency include:

    <p>Being prepared to spend extra time with the patient.</p> Signup and view all the answers

    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?

    <p>Ask the patient if she has developed a suicidal plan.</p> Signup and view all the answers

    Organic brain syndrome is defined as:

    <p>A dysfunction of the brain caused by abnormal physical or physiological function.</p> Signup and view all the answers

    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.
    • 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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    Test your knowledge on behavioral health emergencies with our EMT Chapter 23 flashcards. This quiz focuses on recognizing symptoms and making appropriate interventions in emergency situations. Perfect for EMT students and healthcare professionals alike.

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