EMT – Ch. 26 Behavioral Emergencies

BEHAVIOR
the way a person acts or performs.

BEHAVIORAL EMERGENCY
a situation in which a person exhibits “abnormal” behavior–behavior that is unacceptable or intolerable to the patient, the family, or the community.

Patients in the midst of behavioral emergencies may display what?
panic, agitation, and bizarre thinking and actions.

What are some common reasons why behavior may change in patients?
-Low blood sugar in a diabetic
-Hypoxia (lack of O2)
-Inadequate blood flow to the brain
-Head trauma
-Mind-altering substances, such as alcohol, depressants, stimulants, psychedelics, and narcotics
-Psychogenic substances, which can cause psychotic thinking, depression, or panic
-Excessive cold or heat
-Infections of the brain or its coverings
-Seizure disorder
-Toxic ingestion or overdose
-Drug or alcohol withdrawal

What should you pay particular attention to during your assessment?
-General Appearance
-Speech
-Skin
-Posture or gait
-Orientation
-Memory
-Awareness
-Body Language
-Perception
-Mood
-Judgement

ANXIETY
a state of painful uneasiness about impending problems.

What is one form of anxiety disorder?
panic attack

Patients that are panicked may show what?
intense fear, tension, or restlessness.

What are some physical symptoms in patients with anxiety disorders?
dizziness, tingling around the mouth and fingers, spasms of the hands & feet (carpal-pedal spasms), tremors, irregular heartbeat, palpitations (rapid or intense heartbeat), diarrhea, and sometimes feelings of choking, smothering, or shortness of breath.

PHOBIAS
irrational fears of specific things, places, or situations.

Patients suffering phobias may show evidence of what?
intense fear, tense & restless, they often wring their hands & pace. They frequently suffer from tremors, tachycardia, irregular heartbeat, dyspnea, sweating, and diarrhea.

What is considered the most common psychiatric condition?
depression

DEPRESSION
characterized by deep feelings of sadness, worthlessness, and discouragement, feelings that often do not seem connected to the actual circumstances of the patient’s life.

Depression is a factor in approximately what percent of all suicides?
50%

How do depressed patients usually present themselves?
a sad appearance and may have crying spells and listless or apathetic behavior. They feel helpless, hopeless, withdrawn, and pessimistic; they often suffer appetite loss, sleeplessness, fatigue, despondence, and severe restlessness.

BIPOLAR DISORDER
also known as manic-depressive disorder, causes a patient to swing to opposite sides of the mood spectrum. During one phase, he has an inflated view of himself, feeling happy, elated & superpowerful. The depressive state in which the patient loses interest, feels worthless, worries, and may contemplate suicide.

What are some symptoms that a Bipolar patient may experience in either the manic or depressive stage?
delusions & hallucinations

PARANOIA
a highly exaggerated or unwarranted mistrust or suspiciousness.

PSYCHOSIS
a state of delusion where the patient is out of touch with reality.

Acute psychosis may result from what?
mind-altering drugs, intense stress, delusional disorders, schizophrenia.

SCHIZOPHRENIA
patients with this illness suffer debilitating distortions of speech & though, bizarre delusions, hallucinations, social withdrawal, and lack of emotional expressiveness.

TRUE or FALSE: Schizophrenia manifests as multiple-personality disorder.
FALSE

SUICIDE
any willful act designed to end one’s own life.

Which is four times more likely to die from suicide, males or females?
males

Which make 3 times as many attempts at suicide, males or females?
females

What percentage of suicides are committed with firearms?
55%

What are the most common methods of unsuccessful suicide attempts?
drug ingestion & wrist slashing

Suicide is the 8th leading cause of death in the United States among males & the 3rd leading cause of death of young people between the ages of 15-24.
(INFO)

What are the four most common methods of suicide?
1. self-inflicted gunshot wound
2. hanging
3. poisoning by ingestion
4. carbon monoxide poisoning

The patient who attempts suicide unsuccessfully is at high risk of what?
making a successful attempt later if not helped

AGITATED DELIRIUM
(aka excited delirium) is a mental state & physiological response characterized by: unusual strength & endurance, tolerance of pain, agitation, hostility, frenzied & bizarre behavior, hot & diaphoretic skin, unusual speech

What may agitated delirium be associated with?
drug use, especially cocaine, methamphetamine, and other CNS stimulants and psychiatric illnesses.

Early signs that a person may have lost control & may become violent include:
nervous pacing, shouting, threatening, cursing, throwing objects, clenched teeth and/or fists

What are some basic principles to keep in mind whenever you encounter a behavioral emergency?
1. Every person has limitations
2. Each person has a right to his feelings
3. Each person has more ability to cope with crisis than he might think
4. Everyone feels some emotional disturbance when involved in a disaster or when injured.
5. Emotional injury is just as real as physical injury
6. People who have been through a crisis do not just “get better”
7. Cultural differences have special meaning when you are called to intervene in behavioral emergencies.

Common causes of acute psychotic behavior include all of the following, EXCEPT: Alzheimer disease. When investigating the chief complaint of a psychiatric emergency, the EMT should attempt to determine which of the following? All of these answers are correct. WE …

Hallucinations and delusions are also the other problems which may are commonly caused by medications that the patient is taking and /or dementia. It is expected that 40% to 50% of people with Parkinson’s suffer from this abnormal activity. Hallucination …

Which of the following findings does NOT indicate the potential for violence? A. Large physical body size B. Agitated or depressed C. Uncoordinated movements D. Withdrawn or detached A. Large physical body size When assessing a patient with bizarre behavior, …

Mood Disorder severe mood changes that become severe and result in impaired functioning within the family, work environment, or interpersonal relationships Depression disorder characterized by a sad or despondent mood WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC …

DBT has also been used in adolescents who are suicidal.  In these studies it was found that there were a lot of treatments that were not as effective as DBT in reducing the symptoms in adolescents.  Originally DBT was developed …

Based on the cognitive-behavioral model, mental disorder is a product of behavioral, psychological, and biological factors (Sudak, Beck, and Wright, 2003). In addition, genetic predisposition and psycho-sociological factors trigger the development of mental health problem in an individual. The effect …

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