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Behavioral Emergencies Behavior • Defined as the manner in which a person acts or performs Behavioral Emergency • Exists when a person exhibits abnormal behavior • Behavior that is unacceptable or intolerable to the patient, the family, or the community Physical Causes • • • • • • • • Low blood sugar Lack of oxygen Inadequate blood to the brain Head Trauma Mind-altering substances Excessive cold Excessive heat ALWAYS consider that unusual behavior is caused by something other than a psychological problem Situational Stress Reactions • Severe, unexpected stress will cause patients to display fear, grief, and anger • Apply crisis management skills • Do not rush your patient • Reassure them that you are there to help Psychiatric Emergency • Signs and Symptoms – Panic or anxiety – Unusual appearance, disordered clothing, poor hygiene – Agitated or unusual activity – Unusual speech patterns – Bizarre behavior or thought patterns – Suicidal or self-destructive behavior – Violent or aggressive behavior Patient Care • Be alert – Safety first! • Treat any life-threatening problems • Be prepared to spend time talking with the patient • Encourage the patient to discuss the problem • NEVER play along with visual or auditory hallucinations • Involve family members or friends, IF it helps Suicide • 8th leading cause of death • 3rd leading cause of death in 15-to 24-year olds • Many reasons and methods Suicide Assessment • Factors that indicate a high risk for suicidal behavior: – – – – – – – – – Depression High stress levels Recent emotional trauma Age Alcohol and drug abuse Threats of suicide Suicide plan Previous attempts or threats Sudden improvement form depression Suicide Patient Care • Treatment must begin with scene size-up – safety first! • Treat life-threatening problems – Seek police assistance if necessary • Perform focused history and physical exam • Detailed physical exam – ONLY if safe and the pt has a suspected injury • Ongoing assessment – watch for sudden changes • Contact receiving hospital Aggressive/Hostile Patients • Your assessment may never go beyond initial assessment • Can be caused by various medical conditions – Ex. Metabolic disorders, trauma to the brain, stress Aggressive Patient • The aggressive patient will: – – – – – Respond to people inappropriately Try to hurt himself or others Possibly have a rapid pulse and breathing Display rapid speech and rapid physical movements Appear anxious or nervous Patient Care • Safety first! • Seek advice from medical direction if behavior prevents further assessment • Watch for sudden changes in behavior • Seek assistance from law enforcement Reasonable Force • Always use reasonable amount of force • If restraints are used, be cautious of positional asphyxia
