Term | Definition |
Behavioral emergency | abnormal behavior that is unacceptable
to patients, family members, or society. |
Causes of behavioral emergencies | can be physiological or
psychological. |
Physiological causes | include diabetic emergency; hypoxia;
head injury; drugs, alcohol, or toxins; environmental
emergencies; and seizures |
Psychological causes include
anxiety | unusual level of stress about an event or
problem |
bipolar disorder | also known as manic depression;
characterized by drastic mood swings |
depression | deep sadness not associated with a specific event |
paranoia | extreme suspicion or distrust about others
v. phobias: unusual level of fear about specific things
vi. psychosis: delusional state |
schizophrenia | a state characterized by disorganized
speech and thinking |
Suicide Facts | Females are more likely to attempt suicide, but males are
more likely to die as a result of suicide.
Suicide attempts usually involve firearms, drugs, or alcohol.
Most suicidal patients will give clear signals of their intent. |
All suicidal gestures | should be taken seriously, especially when
patients have a clear plan and the means to carry it out. |
Risk Factors for Suicide | History of mental illness, previous suicide attempts, or child abuse
Recent diagnosis of serious illness
Recent loss of job, family member, or partner
Divorced or widowed |
High-Risk Situations | Suicidal patients
Patients with agitated delirium
Agitated delirium is characterized by violent,
unpredictable behavior, and unusual strength and pain
tolerance. |
High-Risk Situations | It is often associated with use of methamphetamine or
other central nervous system (CNS) stimulants.
Agitated delirium patients are at high risk of sudden
cardiac arrest. |
Warning Signs of Potential Violent Behavior | Threats or threatening behavior, throwing or striking other
objects
Pacing or clenched fists
Swearing or shouting |
PATIENT RESTRAINT | Thoroughly document the following for any call requiring patient
restraint:
The patient's presentation, demeanor, etc.
The reason for restraint and method of restraint
The time and duration of restraint |
PATIENT RESTRAINT | Continuous monitoring of the patient's level of consciousness
(LOC), airway, breathing, and circulator status
The patient's pulses, skin color, and temperature in the
extremities distal to the restraint devices
The role of law enforcement and medical direction
The patient's status upon transfer of care |
ASSESSMENT AND MANAGEMENT | Implement the following techniques when managing
behavioral patients:
Give patient adequate space, and be prepared for rapid
changes in behavior.
Don't block the patient's means of exit or display a
judgmental attitude. |
ASSESSMENT AND MANAGEMENT | Listen actively and don't interrupt.
Don't leave the patient alone. Don't leave your partner
alone with the patient.
Don't give ultimatums. |