Psychiatric Emergencies: Mental Status Exam
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Questions and Answers

What is the typical oral dose of THC when consumed as an edible?

  • 10 milligrams (correct)
  • 5 milligrams
  • 20 milligrams
  • 15 milligrams

Which of the following is commonly associated with frequent THC use?

  • An increase in appetite
  • Cyclic vomiting syndrome (correct)
  • Improved memory function
  • Enhanced mood stability

What is a suggested effective treatment for cyclic vomiting syndrome in THC users?

  • Reglan
  • Ibuprofen
  • Haldol (correct)
  • Zofran

What unconventional treatment has shown success for cyclic vomiting in some patients?

<p>Capsaicin cream application (A)</p> Signup and view all the answers

Why is it important to be cautious with THC products in pediatric patients?

<p>They can lead to overdose and severe symptoms. (A)</p> Signup and view all the answers

What is a risk factor that may lead to an increased incidence of drug intoxication in younger populations?

<p>Increased availability of appealing THC products (B)</p> Signup and view all the answers

What therapy has NOT shown success in treating cyclic vomiting syndrome related to THC?

<p>Zofran (B), Reglan (D)</p> Signup and view all the answers

Which of the following types of products may pose a risk of overdose in adolescents?

<p>A large bag of THC-infused gummies (D)</p> Signup and view all the answers

How are some individuals attempting to alleviate cyclic vomiting at home?

<p>Applying capsaicin from home-prepared hot peppers (C)</p> Signup and view all the answers

What challenges are presented by the new availability of synthetic drugs?

<p>They can be easily obtained at convenience stores. (D)</p> Signup and view all the answers

What is the primary concern when caring for patients who use unregulated drugs?

<p>The potential for adverse reactions (C)</p> Signup and view all the answers

Which symptoms are commonly increased in patients using stimulants?

<p>Increased heart rate and agitation (C)</p> Signup and view all the answers

What should you do to protect yourself when transporting a patient requiring medical attention?

<p>Take a police officer or another person with you (D)</p> Signup and view all the answers

In the case of suspected alcohol intoxication, what is an important test to conduct on the patient?

<p>Blood glucose assessment (A)</p> Signup and view all the answers

What mnemonic is used to remember the components of a mental status exam?

<p>C O A S T M A P (C)</p> Signup and view all the answers

Which component is NOT included in the Coast Map assessment?

<p>Respiration rate (B)</p> Signup and view all the answers

What should be assessed to determine a patient's memory function?

<p>Their short-term and long-term memory (B)</p> Signup and view all the answers

In what scenario should physical restraints be considered for a patient?

<p>When the patient's safety or healthcare team safety is at risk (A)</p> Signup and view all the answers

When should restraints be used on patients?

<p>When there is a potential danger to safety (C)</p> Signup and view all the answers

What potential issue can arise if a patient is assumed to be alcohol intoxicated without proper testing?

<p>Serious underlying health issues may be overlooked (B)</p> Signup and view all the answers

What should you evaluate to assess a patient's perception during a mental health exam?

<p>Any hallucinations or misinterpretations of their environment (A)</p> Signup and view all the answers

What is the recommended practice regarding personnel when restraining a patient?

<p>Having at least one partner present for safety (B)</p> Signup and view all the answers

Which type of restraints can be used in addition to physical ones?

<p>Chemical restraints like sedatives (A)</p> Signup and view all the answers

What should be done if police are on the scene when restraining a patient?

<p>Pull them into the truck to assist or stand by (D)</p> Signup and view all the answers

Why is it important to memorize medication doses for chemical restraints?

<p>To avoid having to look up doses in emergencies (B)</p> Signup and view all the answers

What should you avoid doing when needing medication during a crisis?

<p>Scrolling through protocols for the correct dose (C)</p> Signup and view all the answers

What is the primary goal when using restraints on a patient?

<p>To ensure team and patient safety (D)</p> Signup and view all the answers

What is a potential chemical restraint option mentioned in the context?

<p>Benzodiazepines (D)</p> Signup and view all the answers

Which situation does not warrant the use of restraints?

<p>When the patient is disruptive but harmless (A)</p> Signup and view all the answers

What approach should be taken towards team safety while restraining patients?

<p>Use the minimum force necessary (A)</p> Signup and view all the answers

Flashcards

THC Oral Dosage

The typical oral dose of THC is 10 milligrams.

THC Overdose Presentation

Patients frequently present with overdoses of THC gummies in prehospital settings.

High THC Consumption

Children and adolescents may frequently abuse large quantities of THC-containing products.

Cyclic Vomiting Syndrome (CVS) Trigger

Frequent THC use can be a trigger for CVS in some patients.

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Haldol for CVS

Haldol is often effective in stopping vomiting associated with CVS.

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Unconventional CVS Treatment

Topical capsaicin cream on the abdomen may alleviate CVS symptoms for some.

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Synthetic THC Availability

Synthetic THC is readily available at gas stations.

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Synthetic Drugs Availability

Other synthetic drugs are also commonly found in gas stations or smoke shops.

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Appropriate Dose of Gummies

Appropriate doses (2-3 gummies) vary markedly, resulting in severe symptoms with improper doses.

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EDIBLE THc Danger

Large amounts of THC edibles are particularly dangerous in a young patient population, with high potential for overdosing.

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Unregulated Drugs

Drugs not regulated by the FDA or ATF, making their effects unpredictable and symptom-reversal challenging.

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Stimulant Effects

Stimulants increase heart rate, blood pressure, body temperature, and agitation in patients.

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Patient Safety

Protecting yourself, alongside the patient's care, is crucial during transport.

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Alcohol Intoxication Assessment

Assess blood glucose in addition to usual tests for intoxicated patients.

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Hypoglycemia vs. Intoxication

Hypoglycemia can mimic the symptoms of alcohol intoxication.

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Mental Status Exam

An assessment method (COAST MAP) used to evaluate patients with psychiatric or mental illnesses.

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GCS (Glasgow Coma Scale)

Assessment of a patient's responsiveness.

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Orientation Test

Checking if patients know who/where they are and the current time.

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Physical Restraints

Using force or mechanincal devices to control a patient only in cases of immediate risk.

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Mental Health Content

A patient's thoughts can reveal underlying mental health issues apart of their speech, affect etc.

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Restraints: When?

Restraints are used only in situations where the patient poses a danger to themselves or others, minimizing force and restraint usage.

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Restraint Personnel

Ensure adequate personnel are present for safe patient restraint, including a partner and possibly law enforcement.

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Dosage Knowledge

Doses for chemical restraints must be memorized and readily available, avoiding time-consuming protocol review during emergencies.

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Chemical Restraint Use

Chemical restraints are reserved for urgent situations, prioritizing patient and team safety.

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Restraint Purpose

Restraints aim to minimize injuries to both the patient and the EMT team.

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Law Enforcement Assistance

Law enforcement officers can assist with restraint, providing additional support and security.

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Chemical Restraint Protocols

Always follow local protocols and guidelines for administering chemical restraints.

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Restraint as Last Resort

Restraints are used as a last resort after other de-escalation techniques have failed.

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Safe and Ethical Practice

Restraint should always be used ethically and with the utmost concern for the patient's well-being.

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Study Notes

Psychiatric Emergencies - Mental Status Exam & Risk Factors

  • Mental Status Exam (Coast Map): Use this assessment for patients with psychiatric illnesses. Mnemonic: C O A S T M A P
    • Consciousness: Evaluate Glasgow Coma Scale (GCS).
    • Orientation: Assess awareness of self, location, time (date & year), and possibly current events (president).
    • Activity: Observe appropriate level of activity. Note if it's abnormally high or flat.
    • Speech: Evaluate speed and content (e.g., flight of ideas).
    • Thoughts: Assess thought content (e.g., delusions). Example: patient describing a violin in their abdomen.
    • Memory: Evaluate short-term and long-term memory.
    • Affect/Mood: Assess emotional state.
    • Perception: Assess patient's perception of environment (e.g., hallucinations). Example of a patient hearing dogs barking.

Substance Use & Intoxication

  • THC (Tetrahydrocannabinol):

    • Increasing availability, especially in edible forms.
    • Typical oral dose: 10 mg.
    • Overdose: Large quantities of THC gummies can cause severe illness. Example: patient eating entire 1000 mg bag.
    • Cyclic Vomiting Syndrome (CVS): A common presentation in frequent THC users.
      • Treatment: Haldol often effective, while typical antiemetics (Reglan, Zofran) are less effective in THC-related CVS.
      • Unconventional Treatment: Topical capsaicin cream (hot pepper application) sometimes used successfully in CVS treatment.

  • Synthetic THC & Other Drugs:

    • Lack of Regulation: These unregulated substances pose uncertainty regarding their composition and effects. Found in gas stations and smoke shops
    • Stimulants: Increase heart rate, blood pressure, body temperature, and agitation in patients.
      • Safety: Ensure safety during transport of these patients. Don't handle alone. Bring support (e.g., Police) to transport and care for patient

  • Alcohol Intoxication:

    • Glucose Check: Essential in suspected alcohol intoxication to rule out hypoglycemia or very high hyperglycemia as underlying cause of symptoms.
    • Case Study: Example of a patient misdiagnosed as acutely intoxicated due to absence of glucose assessment, highlighting the importance of a proper assessment. In this case, a very high glucose level, not alcohol, was the cause

Restraint Use

  • Physical Restraints: Used for patient safety or team safety.

    • Conditions requiring restraint: the patient's behavior directly threatens the safety of the patient or responders.
    • Minimal Force: Use the minimum necessary restraints & avoid non-essential use.
    • Personnel: Ensure adequate staff in the vehicle to support safe restraint procedures. Consider bringing police as back-up assistance

  • Chemical Restraints (Benzodiazepines):

    • Necessary medication dosages should be memorized for faster and safer administration in emergencies
    • Protocols: Follow local protocols for administrations.

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Description

Dive into the essential components of the Mental Status Exam using the COAST MAP mnemonic. Learn to assess psychiatric patients effectively by evaluating consciousness, orientation, activity, speech, thoughts, memory, affect/mood, and perception. This quiz will enhance your understanding of psychiatric emergencies.

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