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Behavioral emergencies. be careful!. Possible Causes. Alcohol & drugs Head injury Metabolic disorders (diabetes, renal) Neurological Psychiatric illness Stress response. Managing a Disruptive Situation. protect self and others be prepared to spend extra time have a plan of action

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possible causes
Possible Causes
  • Alcohol & drugs
  • Head injury
  • Metabolic disorders (diabetes, renal)
  • Neurological
  • Psychiatric illness
  • Stress response
managing a disruptive situation
Managing a Disruptive Situation
  • protect self and others
  • be prepared to spend extra time
  • have a plan of action
  • reduce distractions
  • take charge - be confident
  • Do not get too close
  • avoid fighting
  • summon law enforcement prn
don t
DON’T
  • diagnose
  • judge
  • label
  • express accusations and anger
consent
Consent
  • not mentally competent = implied consent.
  • not always clear-cut with psychiatric emergencies
  • If you are not sure, request law enforcement assistance.
restraints
Restraints
  • Use only in emergency
  • Transport without restraints if possible
  • If you must restrain, use only reasonable force.
    • Law enforcement personnel should be involved.
suicide
Suicide
  • Depression is the single most significant factor
  • An attempted suicide is a cry for help
  • Immediate intervention is necessary
  • patients will usually exhibit warning signs
suicidal patients
Suicidal Patients
  • protect self & others
  • do not leave alone
  • question patient regarding his/her feelings & prior attempts
  • ask open ended questions
  • keep direct eye contact
  • If injured or OD - treat appropriately
  • Suicidal Ideations - incompetent
potentially violent patients
Potentially Violent Patients
  • Use a list of risk factors to assess the level of danger:
    • Past history
    • Posture
    • Scene
    • Vocal activity
    • Physical activity
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