Behavioral Emergencies Chapter 33 Guillermo De La Renta.
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Transcript of Behavioral Emergencies Chapter 33 Guillermo De La Renta.
Behavioral EmergenciesChapter 33
Guillermo De La Renta
OK so…
Behavior….
• An individuals action or reaction in response to external or internal stimuli• Can be normal or
abnormal (subjective)
Behavioral emergency….
• A form of altered mental status• Behavior abnormal
within the context of the situation• Variety of causes
Neurosis vs Psychosis…
Neurosis
• Person exhibits abnormal behavior, but remains able to understand the normal boundaries of reality
Ex. • Anxiety• Depression• Paranoia• agitation
Psychosis • Person exhibits
abnormal behavior, and has altered perceptions of reality• Ex.• Schizophrenia• Bipolar disorder
Causes of behavioral emergencies
• Medical disorders• AMS possible NOI• Underlying issue often hypoxia, hypoglycemia• Ex. Epilepsy, hypotension, diabetes…
• Chemical exposures• Alcohol, drugs• Frequent cause of BE• Prescription or recreational (ex. Insulin vs. alcohol)
• Trauma• Brain injuries cause AMS and behavioral disorders
• TBI wide range of symptoms• Blood loss hypoxia in brain• Hypo and hyperthermia brain is pissed
• Behavioral conditions• Your psyche is complex • I.e. psychiatric s%&*
Signs and symptoms• Agitation• Paranoia• Stress-laden speech• Bizarre actions or
thoughts• Self-destructive behavior• Mental confusion• Hostility• Uncontrolled (scream)
crying
Assessment and Treatment
Assessment
• Scene safety BEs can escalate • (0 100, real quickly)
• Consider possible contexts• Try to notice subtle
behaviors• Don’t forget about basic
documentation and assessment (SAMPLE, oprst, vitals…)
Management
• Preventative • Keep patient and rescuers
safe• Supportive • Correct potential threats to
life• Assume behavior is from
medical condition treat accordingly
Restraint
Indications
• When patient is endangering self or others
How-to!
• Best done by LEO
• Reasonable force
• Ideally, minimum 5 people