Behavioral Behavioral EmergenciesEmergencies

BehaviorBehavior

• Defined as the manner in which a Defined as the manner in which a person acts or performsperson acts or performs

Behavioral EmergencyBehavioral Emergency

• Exists when a person exhibits Exists when a person exhibits abnormal behaviorabnormal behavior

• Behavior that is unacceptable or Behavior that is unacceptable or intolerable to the patient, the family, intolerable to the patient, the family, or the communityor the community

Physical CausesPhysical Causes

• Low blood sugarLow blood sugar• Lack of oxygenLack of oxygen• Inadequate blood to the brainInadequate blood to the brain• Head TraumaHead Trauma• Mind-altering substancesMind-altering substances• Excessive coldExcessive cold• Excessive heatExcessive heat• ALWAYS consider that unusual behavior ALWAYS consider that unusual behavior

is caused by something other than a is caused by something other than a psychological problempsychological problem

Situational Stress Situational Stress ReactionsReactions

• Severe, unexpected stress will cause Severe, unexpected stress will cause patients to display fear, grief, and patients to display fear, grief, and angeranger

• Apply crisis management skillsApply crisis management skills• Do not rush your patientDo not rush your patient• Reassure them that you are there to Reassure them that you are there to

helphelp

Psychiatric EmergencyPsychiatric Emergency

• Signs and SymptomsSigns and Symptoms– Panic or anxietyPanic or anxiety– Unusual appearance, disordered Unusual appearance, disordered

clothing, poor hygieneclothing, poor hygiene– Agitated or unusual activityAgitated or unusual activity– Unusual speech patternsUnusual speech patterns– Bizarre behavior or thought patternsBizarre behavior or thought patterns– Suicidal or self-destructive behaviorSuicidal or self-destructive behavior– Violent or aggressive behaviorViolent or aggressive behavior

Patient CarePatient Care

• Be alert – Safety first!Be alert – Safety first!• Treat any life-threatening problemsTreat any life-threatening problems• Be prepared to spend time talking with the Be prepared to spend time talking with the

patientpatient• Encourage the patient to discuss the Encourage the patient to discuss the

problemproblem• NEVER play along with visual or auditory NEVER play along with visual or auditory

hallucinationshallucinations• Involve family members or friends, IF it Involve family members or friends, IF it

helpshelps

SuicideSuicide

• 88thth leading cause of death leading cause of death • 33rdrd leading cause of death in 15-to leading cause of death in 15-to

24-year olds24-year olds• Many reasons and methodsMany reasons and methods

Suicide AssessmentSuicide Assessment

• Factors that indicate a high risk for suicidal Factors that indicate a high risk for suicidal behavior:behavior:– DepressionDepression– High stress levelsHigh stress levels– Recent emotional traumaRecent emotional trauma– AgeAge– Alcohol and drug abuseAlcohol and drug abuse– Threats of suicideThreats of suicide– Suicide planSuicide plan– Previous attempts or threatsPrevious attempts or threats– Sudden improvement form depressionSudden improvement form depression

Suicide Patient CareSuicide Patient Care

• Treatment must begin with scene size-up – Treatment must begin with scene size-up – safety first!safety first!

• Treat life-threatening problemsTreat life-threatening problems– Seek police assistance if necessarySeek police assistance if necessary

• Perform focused history and physical examPerform focused history and physical exam• Detailed physical examDetailed physical exam

– ONLY if safe and the pt has a suspected injuryONLY if safe and the pt has a suspected injury

• Ongoing assessment – watch for sudden Ongoing assessment – watch for sudden changeschanges

• Contact receiving hospitalContact receiving hospital

Aggressive/Hostile Aggressive/Hostile PatientsPatients

• Your assessment may never go Your assessment may never go beyond initial assessmentbeyond initial assessment

• Can be caused by various medical Can be caused by various medical conditionsconditions– Ex. Metabolic disorders, trauma to the Ex. Metabolic disorders, trauma to the

brain, stressbrain, stress

Aggressive PatientAggressive Patient

• The aggressive patient will:The aggressive patient will:– Respond to people inappropriatelyRespond to people inappropriately– Try to hurt himself or othersTry to hurt himself or others– Possibly have a rapid pulse and Possibly have a rapid pulse and

breathingbreathing– Display rapid speech and rapid physical Display rapid speech and rapid physical

movementsmovements– Appear anxious or nervousAppear anxious or nervous

Patient CarePatient Care

• Safety first!Safety first!• Seek advice from medical direction Seek advice from medical direction

if behavior prevents further if behavior prevents further assessmentassessment

• Watch for sudden changes in Watch for sudden changes in behaviorbehavior

• Seek assistance from law Seek assistance from law enforcementenforcement

Reasonable ForceReasonable Force

• Always use reasonable amount of Always use reasonable amount of forceforce

• If restraints are used, be cautious of If restraints are used, be cautious of positional asphyxiapositional asphyxia