EMT Flashcards Chapter 20

Questions and Answers

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

Neurosis

Psychosis

Affect

Behavior (correct)

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

A situation in which a patient demonstrates bizarre behavior and becomes a risk to other people.

A sudden, violent outburst of an otherwise mentally stable person toward a family member.

Any reaction that interferes with activities of daily living or is deemed unacceptable by others. (correct)

A period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications.

From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least:

1 week

1 month (correct)

2 weeks

3 weeks

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

Demonstrates agitation or violence or becomes a threat to himself or herself, or to others. Signup and view all the answers

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

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

Organic brain syndrome is MOST accurately defined as:

A dysfunction of the brain caused by abnormal physical or physiological function. 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:

Inquire about the possibility of head trauma. Signup and view all the answers

Which of the following conditions or factors would be the LEAST likely to result in a change in behavior?

Antihypertensive medications Signup and view all the answers

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

Schizophrenia Signup and view all the answers

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

Ensure your safety. Signup and view all the answers

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:

Remain in a safe place and request law enforcement. Signup and view all the answers

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

Being prepared to spend extra time with the patient. 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:

Calmly identify yourself to the patient. Signup and view all the answers

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

Be direct and clearly state your intentions. 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 unconscious and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:

Open the patient's airway and assess his respirations. 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:

Ask the daughter how her father normally behaves. 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:

Reflective listening Signup and view all the answers

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

A physical examination for a behavioral problem may be difficult to perform but may provide clues to the patient's state of mind and thought processes. 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?

Rapid eye movement Signup and view all the answers

Assessing the blood pressure and oxygen saturation of a patient with a behavioral crisis should be performed:

If doing so will not worsen his or her emotional distress. Signup and view all the answers

In addition to ensuring his or her own safety, the EMT's responsibility when caring for a patient with a behavioral emergency is to:

Diffuse and control the situation and safely transport the patient. Signup and view all the answers

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

Alzheimer's disease Signup and view all the answers

The single most significant factor that contributes to suicide is:

Depression 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?

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

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

Married males older than 30 years. Signup and view all the answers

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

Be homicidal as well. Signup and view all the answers

Signs of agitated delirium include:

Diaphoresis, tachycardia, and hallucinations. Signup and view all the answers

Law enforcement personnel request your assistance for a 30-year-old man who they 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:

Limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you. 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:

Restrain the patient with appropriate force in order to treat his injuries. 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?

His large body Signup and view all the answers

Study Notes

Key Concepts in Behavioral Emergencies

Affect vs. Behavior: Affect refers to visible emotional responses, while behavior encompasses a person’s actions or reactions to the environment.
Behavioral Crisis Definition: A behavioral crisis is characterized by actions that disrupt daily living or are socially unacceptable.

Duration of Disturbing Behavior

Behavioral changes are concerning when they persist for at least one month, indicating a threshold for potential treatment need.

Psychiatric Emergencies vs. Behavioral Crises

A psychiatric emergency is marked by agitation or threats to self/others, unlike a behavioral crisis where the focus is on the disruption of normal life.

Assessment Protocols

EMTs should assess bizarre behavior as potential medical emergencies, considering underlying medical conditions that may affect behavior.
Organic brain syndrome is defined as impaired brain function due to physical sickness or injury.

Safety and Initial Response

Ensuring the safety of the EMT is paramount when managing patients with behavioral emergencies, followed by establishing communication and evaluation.
In cases of imminent risk (e.g., known access to weapons), response should prioritize safety and possibly involve law enforcement.

Management Techniques

Use reflective listening techniques to understand a patient's thoughts by paraphrasing their statements.
A physical examination may be beneficial; it can't be bypassed even if the patient is violent.

Clinical Indicators and Risks

Changes in behavior could suggest central nervous dysfunction, with specific indicators such as rapid eye movement being more telling.
The chief risk factor for suicide is depression, which must be assessed carefully during evaluations.

Key Signs of Distress and Crisis

Symptoms of agitated delirium include excessive sweating, rapid heartbeat, and hallucinations, indicating severe distress.
Patients experiencing hallucinations or violent behavior require careful management to de-escalate the situation safely.

Historical Context and Patient Management

Previous conditions, such as schizophrenia, necessitate specific management strategies, ensuring the patient receives care while maintaining safety through potential restraint.
Violence risk may be inferred from multiple behavioral cues; however, aspects like physical size may not be as indicative compared to actions like clenched fists or aggressive shouting.

Common Misconceptions

Not all factors contribute equally to behavior changes; antihypertensive medications, for example, are less likely to cause change than other listed conditions.
Care for suicidal patients should emphasize open communication about plans and thoughts of self-harm to effectively manage their situation.

Summary of Priorities

Prioritize assessment and management of suicidal thoughts, with plans and law enforcement intervention if necessary, and focus on de-escalation and understanding in cases of severe aggression or psychosis.

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Description

Test your knowledge with these EMT flashcards focused on Chapter 20 concepts. This quiz covers critical definitions and terms essential for understanding behavioral responses and crises in emergency medical situations.