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Psychiatric Emergencies PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Psychiatric Emergencies".

This medical PowerPoint presentation talks about psychiatric emergencies, situations where a person is experiencing a mental health crisis that requires immediate intervention to prevent harm to themselves or others.

Some common examples of psychiatric emergencies include suicide attempts or suicidal thoughts, homicidal ideation or violent behavior, severe agitation or aggression, delusional thinking or hallucinations, severe depression or anxiety, substance abuse or overdose, acute psychosis or mania, and acute withdrawal from drugs or alcohol, etc.

Tags : Psychiatric Emergencies, suicide attempts, suicidal thoughts, homicidal ideation, violent behavior, severe agitation, Emergency Medicine, Emergency Medicine PowerPOint presentation

Published on : Apr 12, 2023 | Views : 2943 | Downloads : 2

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Slide 1-

Chapter 20 Psychiatric Emergencies
Slide 2-

National EMS Education Standard Competencies (1 of 2) Medicine Applies fundamental knowledge to provide basic emergency care and transportation based on assessment findings for an acutely ill patient.
Slide 3-

National EMS Education Standard Competencies (2 of 2) Psychiatric Recognition of: Behaviors that pose a risk to the EMT, patient, or others Basic principles of the mental health system Assessment and management of: Acute psychosis Suicidal/risk Agitated delirium
Slide 4-

Introduction EMTs often deal with patients undergoing psychological or behavioral crisis. Crisis might be the result of: Emergency situation Mental illness Mind-altering substances Stress
Slide 5-

Myth and Reality (1 of 3) We all develop some symptoms of mental illness at some point in life. Does not mean that everyone develops mental illness Do not jump to conclusions concerning: Yourself Your patient
Slide 6-

Myth and Reality (2 of 3) The most common misconception is that if you are feeling “bad” or “depressed,” you must be “sick.” There are many justifiable reasons for feeling depressed, such as: Divorce Loss of a job Death of a relative or friend
Slide 7-

Myth and Reality (3 of 3) Many people believe that all individuals with mental health disorders are dangerous, violent, or unmanageable. Only a small percentage fall into this category. You may be exposed to a higher proportion of violent patients. You may be able to predict violence.
Slide 8-

Defining a Behavioral Crisis (1 of 4) Behavior is what you can see of a person’s response to the environment: his or her actions. Most of the time, people respond to the environment in reasonable ways. There are times when stress is so great that the normal ways do not work.
Slide 9-

Defining a Behavioral Crisis (2 of 4) A behavioral crisis is any reaction to events that interferes with the activities of daily living or has become unacceptable to the patient, family, or community. If this interruption tends to occur on a regular basis, the behavior is also considered a mental health problem.
Slide 10-

Defining a Behavioral Crisis (3 of 4) Usually, if an abnormal pattern of behavior lasts for at least a month, it is a matter of concern. Chronic depression is a persistent feeling of sadness and despair. May be a symptom of a mental or physical disorder
Slide 11-

Defining a Behavioral Crisis (4 of 4) When a psychiatric emergency arises, the patient: May show agitation or violence May become a threat to self or others
Slide 12-

The Magnitude of Mental Health Problems (1 of 2) At one time or another, one in five Americans has some type of psychiatric disorder. An illness with psychological or behavioral symptoms that may result in impaired functioning
Slide 13-

The Magnitude of Mental Health Problems (2 of 2) The US mental health system provides many levels of assistance. Professional counselors are available for marital conflict and parenting issues. More serious issues are often handled by a psychologist. Severe psychological conditions require a psychiatrist.
Slide 14-

Pathology (1 of 4) An EMT is not responsible for diagnosing the underlying cause of a behavioral crisis or psychiatric emergency. You should know the two basic categories of diagnosis a physician will use: organic and functional.
Slide 15-

Pathology (2 of 4) Organic Organic brain syndrome is a temporary or permanent dysfunction of the brain caused by a disturbance in the physical or physiologic functioning of the brain tissue. Causes include sudden illness, head trauma, seizures, intoxication, and diseases of the brain
Slide 16-

Pathology (3 of 4) Organic (cont’d) Altered mental status can arise from: Low level of blood glucose Lack of oxygen Inadequate blood flow to brain Excessive heat or cold
Slide 17-

Pathology (4 of 4) Functional Abnormal operation of an organ that cannot be traced to an obvious change in the organ itself Examples include schizophrenia, anxiety conditions, and depression. There may be a chemical or physical cause, but it is not well understood.
Slide 18-

Safe Approach to a Behavioral Crisis (1 of 2) All regular EMT skills are used in a behavioral crisis. However, other management techniques come into play.
Slide 19-

Safe Approach to a Behavioral Crisis (2 of 2)
Slide 20-

Patient Assessment Patient assessment steps Scene size-up Primary assessment History taking Secondary assessment Reassessment
Slide 21-

Scene Size-up (1 of 2) Scene safety Is the situation unduly dangerous to you and your partner? Do you need immediate law enforcement backup? Does the patient’s behavior seem typical or normal for the circumstances? Are there legal issues involved?
Slide 22-

Scene Size-up (2 of 2) Mechanism of injury/nature of illness Determine the MOI and/or NOI.
Slide 23-

Primary Assessment (1 of 3) Form a general impression. Begin your assessment from the doorway or from a distance. Perform a rapid scan. Observe the patient closely using the AVPU scale to check for alertness. Establish a rapport with the patient.
Slide 24-

Primary Assessment (2 of 3) Airway and breathing Assess the airway to make sure it is patent and adequate. Evaluate the patient’s breathing. Circulation Assess the pulse rate, quality, and rhythm. Obtain the systolic and diastolic BP. Evaluate skin color, temperature, condition.
Slide 25-

Primary Assessment (3 of 3) Transport decision Unless your patient is unstable from a medical problem or trauma, prepare to spend time at the scene with him or her. There may be a specific facility to which patients with mental problems are transported.
Slide 26-

History Taking (1 of 3) Investigate the chief complaint. Is the patient’s central nervous system functioning properly? Are hallucinogens or alcohol a factor? Are psychogenic circumstances involved?
Slide 27-

History Taking (2 of 3) SAMPLE history You may be able to elicit information not available to the hospital staff.
Slide 28-

History Taking (3 of 3) SAMPLE history (cont’d) In geriatric patients, consider Alzheimer disease and dementia. Your assessment has two primary goals: Recognizing major life threats Reducing the stress of the situation Use reflective listening.
Slide 29-

Secondary Assessment (1 of 4) Physical examinations In an unconscious patient, begin with a full-body scan. Avoid touching the patient without permission. A conscious patient may not respond at all to your questions.
Slide 30-

Secondary Assessment (2 of 4) Physical examinations (cont’d) You can tell a lot about a patient’s emotional state from: Facial expressions Pulse rate Respirations
Slide 31-

Secondary Assessment (3 of 4) Vital signs Obtain vital signs when doing so will not exacerbate the patient’s emotional distress. Make every effort to assess blood pressure, pulse, respirations, skin, and pupils.
Slide 32-

Secondary Assessment (4 of 4) Vital signs (cont’d) Monitoring devices may be used. Assess the patient’s first blood pressure with a sphygmomanometer and a stethoscope. A pulse oximetry device can be used to assess the patient’s perfusion status.
Slide 33-

Reassessment (1 of 3) Never let your guard down. Many patients will act spontaneously. If restraints are necessary, reassess and document every 5 minutes: Respirations Pulse and motor and sensory function in all restrained extremities
Slide 34-

Reassessment (2 of 3) Interventions There is often little you can do during the short time you will be treating the patient. Diffuse and control the situation. Safely transport the patient to the hospital. Intervene only as much as it takes to accomplish these tasks.
Slide 35-

Reassessment (3 of 3) Communication and documentation Try to give the receiving hospital advance warning of the psychiatric emergency. Document thoroughly and carefully. Yours may be the only documentation about the patient’s distress. If restraints are used, say what types and why they were used.
Slide 36-

Acute Psychosis (1 of 5) Psychosis is a state of delusion in which the person is out of touch with reality. Causes include: Mind-altering substances Intense stress Delusional disorders Schizophrenia
Slide 37-

Acute Psychosis (2 of 5) Schizophrenia is a complex disorder that is not easily defined or treated. Typical onset occurs during adulthood. Influences thought to contribute include: Brain damage Genetics Psychological and social influences
Slide 38-

Acute Psychosis (3 of 5) Persons with schizophrenia experience symptoms including: Delusions Hallucinations A lack of interest in pleasure Erratic speech
Slide 39-

Acute Psychosis (4 of 5) Guidelines for dealing with a psychotic patient: Determine if the situation is dangerous. Identify yourself clearly. Be calm, direct, and straightforward. Maintain an emotional distance. Do not argue.
Slide 40-

Acute Psychosis (5 of 5) Guidelines (cont’d) Explain what you would like to do. Involve people the patient trusts, such as family or friends, to gain patient cooperation.
Slide 41-

Suicide (1 of 5) Depression is the most significant factor that contributes to suicide. It is a common misconception that people who threaten suicide never commit it. Suicide is a cry for help. Someone is in a crisis that he or she cannot handle alone.
Slide 42-

Suicide (2 of 5)
Slide 43-

Suicide (3 of 5) Be alert to these warning signs: Does he or she have an air of tearfulness, sadness, deep despair, or hopelessness? Does he or she avoid eye contact, speak slowly, and project a sense of vacancy? Does he or she seem unable to talk about the future? Is there any suggestion of suicide? Does he or she have any plans relating to death?
Slide 44-

Suicide (4 of 5) Consider these additional risks: Are there any unsafe objects nearby? Is the environment unsafe? Is there evidence of self-destructive behavior? Is there an imminent threat to the patient or others?
Slide 45-

Suicide (5 of 5) Additional risks (cont’d) Is there an underlying medical problem? Are there cultural or religious beliefs promoting suicide? Has there been any trauma? A suicidal patient may be homicidal as well.
Slide 46-

Agitated Delirium (1 of 5) Delirium is a condition of impairment in cognitive function that can present with disorientation, hallucinations, or delusions. Agitation is characterized by restless and irregular physical activity. Patients may strike out irrationally. Your personal safety must be considered.
Slide 47-

Agitated Delirium (2 of 5) Symptoms may include: Hyperactive irrational behavior Inattentiveness Vivid hallucinations Hypertension Tachycardia Diaphoresis Dilated pupils
Slide 48-

Agitated Delirium (3 of 5) Be calm, supportive, and empathetic. Approach the patient slowly and purposefully and respect the patient’s territory. Limit physical contact. Do not leave the patient unattended.
Slide 49-

Agitated Delirium (4 of 5) Try to indirectly determine the patient’s: Orientation Memory Concentration Judgment Pay attention to the patient’s ability to communicate, appearance, dress, and personal hygiene.
Slide 50-

Agitated Delirium (5 of 5) If you determine the patient requires restraint, make sure you have adequate personnel available to help you. If the patient has overdosed, take all medication bottles or illegal substances to the medical facility. Refrain from using lights and sirens.
Slide 51-

Medicolegal Considerations (1 of 5) More complicated with patient undergoing behavioral crisis or psychiatric emergency Legal problems are reduced when the patient consents to care. Gaining the patient’s confidence is crucial.
Slide 52-

Medicolegal Considerations (2 of 5) You must decide whether the patient requires immediate emergency medical care. He or she may resist your attempt to provide care. Never leave the patient alone. Request law enforcement personnel to handle the patient.
Slide 53-

Medicolegal Considerations (3 of 5) Consent Implied consent is assumed with a patient who is not mentally competent to grant consent. Consent matters are not always clear-cut in psychiatric emergencies. If you are not sure, request the assistance of law enforcement personnel.
Slide 54-

Medicolegal Considerations (4 of 5) Limited legal authority The EMT has limited legal authority to require a patient to undergo emergency medical care when no life-threatening emergency exists. Competent adults have the right to refuse care.
Slide 55-

Medicolegal Considerations (5 of 5) In psychiatric cases, a court of law would probably consider your actions in providing lifesaving care to be appropriate. A patient who is in any way impaired may not be considered competent. Err on the side of treatment and transport.
Slide 56-

Restraint (1 of 5) If you restrain a person without authority in a nonemergency situation, you expose yourself to a possible lawsuit. Legal actions can involve charges of assault, battery, false imprisonment, and violation of civil rights.
Slide 57-

Restraint (2 of 5) You may use restraints only: To protect yourself or others from bodily harm To prevent the patient from causing injury to himself or herself
Slide 58-

Restraint (3 of 5) You may use only reasonable force as necessary to control the patient. Always try to transport a disturbed patient without restraints if possible. At least four people should be present to carry out the restraint, each being responsible for one extremity.
Slide 59-

Restraint (4 of 5) Level of force will vary, depending on these factors: Degree of force that is necessary to keep the patient from injuring himself, herself, or others Patient’s sex, size, strength, mental status Type of abnormal behavior the patient is exhibiting
Slide 60-

Restraint (5 of 5) Secure the patient’s extremities with approved equipment. Treat the patient with dignity and respect. Monitor the patient for: Vomiting Airway obstruction Cardiovascular stability
Slide 61-

The Potentially Violent Patient (1 of 5) Violent patients make up only a small percentage of behavioral and psychiatric patients. However, the potential for violence is always an important consideration for you.
Slide 62-

The Potentially Violent Patient (2 of 5) History Has the patient previously exhibited hostile, overly aggressive, or violent behavior? Posture How is the patient sitting or standing? Is the patient tense, rigid, or sitting on the edge of his or her seat?
Slide 63-

The Potentially Violent Patient (3 of 5) The scene Is the patient holding or near potentially lethal objects? Vocal activity What kind of speech is the patient using? Loud, obscene, erratic, and bizarre speech patterns usually indicate emotional distress.
Slide 64-

The Potentially Violent Patient (4 of 5) Physical activity Most telling factor of all A patient requiring careful watching is one who: Has tense muscles, clenched fists, or glaring eyes Is pacing Cannot sit still Is fiercely protecting personal space
Slide 65-

The Potentially Violent Patient (5 of 5) Other factors to consider: Poor impulse control A history of truancy, fighting, and uncontrollable temper Tattoos Substance abuse Depression Functional disorder
Slide 66-

Summary (1 of 6) A behavioral crisis is any reaction to events that interferes with the activities of daily living or has become unacceptable to the patient, family, or community.
Slide 67-

Summary (2 of 6) During a psychiatric emergency, a patient may show agitation or violence or become a threat to himself or herself, or to others.
Slide 68-

Summary (3 of 6) Psychiatric disorders have many possible underlying causes including social or situational stress, psychiatric disorders, physical illnesses, chemical problems, or biologic disturbances.
Slide 69-

Summary (4 of 6) As an EMT, you are not responsible for diagnosing the underlying cause of a behavioral crisis or psychiatric emergency. The threat of suicide requires immediate intervention. Depression is the most significant risk factor for suicide.
Slide 70-

Summary (5 of 6) A patient in mentally unstable condition may resist your attempts to provide care. In such situations, request that law enforcement personnel handle the patient. Violent or dangerous people must be taken into custody by the police before emergency care can be rendered.
Slide 71-

Summary (6 of 6) Always consult medical control and contact law enforcement personnel for help before restraining a patient. If restraints are required, use the minimum force necessary. Assess the airway and circulation frequently while the patient is restrained.
Slide 72-

Review (1 of 2) A behavioral crisis is MOST accurately defined as: a severe, acute psychiatric condition in which the patient becomes violent and presents a safety threat to himself or herself, or to others. any reaction to events that interferes with activities of daily living or has become unacceptable to the patient, family, or community.
Slide 73-

Review (2 of 2) A behavioral crisis is MOST accurately defined as: a normal response of a patient to a situation that causes an overwhelming amount of stress, such as the loss of a job or marital problems. a reaction to a stressful event that the patient feels is appropriate, but is considered inappropriate by the patient’s family or the community.
Slide 74-

Review Answer: B Rationale: A behavioral crisis is any reaction to events that interferes with the patient’s activities of daily living or has become acceptable to the patient, his or her family, or the community. Not all patients with an emotional crisis are “psychotic,” nor are all violent patients experiencing a psychiatric condition; these are common misconceptions. Various medical conditions can cause a behavioral crisis (eg, hypoglycemia, hypoxemia, brain tumors).
Slide 75-

Review (1 of 2) A behavioral crisis is MOST accurately defined as: a severe, acute psychiatric condition in which the patient becomes violent and presents a safety threat to himself or herself, or to others. Rationale: This could be considered a symptom of a mental disorder. any reaction to events that interferes with activities of daily living or has become unacceptable to the patient, family, or community. Rationale: Correct answer
Slide 76-

Review (2 of 2) A behavioral crisis is MOST accurately defined as: a normal response of a patient to a situation that causes an overwhelming amount of stress, such as the loss of a job or marital problems. Rationale: This could be normal behavior or could progress to depression. a reaction to a stressful event that the patient feels is appropriate, but is considered inappropriate by the patient’s family or the community. Rationale: This could be normal behavior.
Slide 77-

Review Depression and schizophrenia are examples of: functional disorders. altered mental status. behavioral emergencies. organic brain syndrome.
Slide 78-

Review Answer: A Rationale: Unlike an organic disorder, a functional disorder cannot be linked to any physical dysfunction or failure of an organ. Depression, schizophrenia, obsessive-compulsive disorder (OCD), and bipolar disorder are examples of functional disorders. They are usually caused by a chemical imbalance in the brain—not a structural or physical abnormality.
Slide 79-

Review (1 of 2) Depression and schizophrenia are examples of: functional disorders.Rationale: Correct answer altered mental status.Rationale: A common presentation in patients with a wide variety of medical problems.
Slide 80-

Review (2 of 2) Depression and schizophrenia are examples of: behavioral emergencies.Rationale: Emergencies that do not have a clear physical cause and that result in aberrant behavior. organic brain syndrome.Rationale: A psychiatric disorder caused by a permanent or temporary physical change in the brain.
Slide 81-

Review When assessing a patient with a behavioral crisis, your primary concern must be: allowing the patient to express himself to you in his own words. setting your personal feelings aside and providing needed care. gathering the patient’s belongings and taking them to the hospital. whether the patient will cause harm to you or your partner.
Slide 82-

Review Answer: D Rationale: There are many things that you should be concerned with when assessing a patient with a behavioral crisis, including all of the items listed in this question. Your primary concern, however, must be the safety of yourself and your partner.
Slide 83-

Review (1 of 2) When assessing a patient with a behavioral crisis, your primary concern must be: allowing the patient to express himself to you in his own words.Rationale: This is a good technique used in assessment. setting your personal feelings aside and providing needed care.Rationale: It is important not to allow your own prejudice to interfere with treating patients.
Slide 84-

Review (2 of 2) When assessing a patient with a behavioral crisis, your primary concern must be: gathering the patient’s belongings and taking them to the hospital.Rationale: Good patient skills are utilized in the treatment of every patient. whether the patient will cause harm to you or your partner.Rationale: Correct answer
Slide 85-

Review General guidelines to follow when caring for a patient with a behavioral crisis include all of the following, EXCEPT: being honest and reassuring. rapidly transporting the patient. having a definite plan of action. avoiding arguing with the patient.
Slide 86-

Review Answer: B Rationale: When caring for a patient with a behavioral crisis, the EMT must be prepared to spend extra time with the patient. It may take longer to assess and listen to the patient prior to transport.
Slide 87-

Review General guidelines to follow when caring for a patient with a behavioral crisis include all of the following, EXCEPT: being honest and reassuring.Rationale: This is part of proper treatment. rapidly transporting the patient.Rationale: Correct answer having a definite plan of action.Rationale: This is part of proper treatment. avoiding arguing with the patient.Rationale: This is part of proper treatment.
Slide 88-

Review Reflective listening, an assessment technique used when caring for patients with an emotional crisis, involves: asking the patient to repeat his or her statements. simply listening to the patient, without speaking. asking the patient to repeat everything that you say. repeating, in question form, what the patient tells you.
Slide 89-

Review Answer: D Rationale: Reflective listening—a technique in which you repeat, in question form, what the patient tells you—allows the patient to further expand on his or her thoughts; it also helps the EMT gain insight into the patient’s situation.
Slide 90-

Review (1 of 2) Reflective listening, an assessment technique used when caring for patients with an emotional crisis, involves: asking the patient to repeat his or her statements. Rationale: This is considered to be clarification of a response. simply listening to the patient, without speaking. Rationale: This is considered to be active listening.
Slide 91-

Review (2 of 2) Reflective listening, an assessment technique used when caring for patients with an emotional crisis, involves: asking the patient to repeat everything that you say. Rationale: Simplify and summarize the patient’s response when a patient gives confusing or disorganized responses. repeating, in question form, what the patient tells you. Rationale: Correct answer
Slide 92-

Review Which of the following patients is at HIGHEST risk for suicide? 24-year-old woman who is successfully being treated for depression 29-year-old man who was recently promoted with a large pay increase 33-year-old man who regularly consumes alcohol and purchased a gun 45-year-old woman who recently found out her cancer is in full remission
Slide 93-

Review Answer: C Rationale: Situations or indications that place a patient at high risk for suicide include, but are not limited to, recent diagnosis of a serious illness; financial setback; marital discord; death of a loved one; untreated psychiatric illness; recent acquisition of items that can cause death, such as a gun or knife; and chronic alcohol use.
Slide 94-

Review (1 of 2) Which of the following patients is at HIGHEST risk for suicide? 24-year-old woman who is successfully being treated for depressionRationale: This woman is not a high risk for suicide. 29-year-old man who was recently promoted with a large pay increaseRationale: This man is not a high risk for suicide.
Slide 95-

Review (2 of 2) Which of the following patients is at HIGHEST risk for suicide? 33-year-old man who regularly consumes alcohol and purchased a gunRationale: Correct answer 45-year-old woman who recently found out her cancer is in full remissionRationale: This woman is not a high risk for suicide.
Slide 96-

Review When caring for a patient with an emotional crisis who is calm and not in need of immediate emergency care, your BEST course of action is to: advise the patient that he or she cannot refuse treatment. leave the patient with a trusted friend or family member. attempt to obtain consent from the patient to transport. apply soft restraints in case the patient becomes violent.
Slide 97-

Review Answer: C Rationale: Just because a patient is experiencing an emotional crisis does not mean that he or she is “mentally incompetent” and cannot refuse EMS treatment and/or transport. You should attempt to obtain consent from any conscious patient unless he or she clearly does not have decision-making capacity (eg, under age, altered mental status, alcohol intoxication).
Slide 98-

Review (1 of 2) When caring for a patient with an emotional crisis who is calm and not in need of immediate emergency care, your BEST course of action is to: advise the patient that he or she cannot refuse treatment. Rationale: Do this only if the patient clearly does not have decision-making capacity (eg, under age, intoxicated). leave the patient with a trusted friend or family member. Rationale: Attempt to obtain verbal consent for transport to a medical facility.
Slide 99-

Review (2 of 2) When caring for a patient with an emotional crisis who is calm and not in need of immediate emergency care, your BEST course of action is to: attempt to obtain consent from the patient to transport. Rationale: Correct answer apply soft restraints in case the patient becomes violent. Rationale: Restraints are not often used in situations where a patient might become violent, but they are considered.
Slide 100-

Review When physically restraining a violent patient, the EMT should: continually talk to the patient as he or she is being restrained. check circulation in all extremities only if the patient is prone. remove the restraints if the patient appears to be calming down. use additional force if the restrained patient begins to yell at you.
Slide 101-

Review Answer: A Rationale: When physically restraining a violent patient, the EMT or his or her partner should continually talk to the patient throughout the process. Treat the patient with dignity and respect—regardless of the situation. Once restraints are placed, they should not be removed, even if the patient appears to be calm. Circulation in all extremities should be monitored, regardless of the position in which the patient is restrained.
Slide 102-

Review (1 of 2) When physically restraining a violent patient, the EMT should: continually talk to the patient as he or she is being restrained.Rationale: Correct answer check circulation in all extremities only if the patient is prone.Rationale: Always check the patient’s extremity circulation often when physical restraints are applied.
Slide 103-

Review (2 of 2) When physically restraining a violent patient, the EMT should: remove the restraints if the patient appears to be calming down.Rationale: Once restraints are applied, they should not be removed. use additional force if the restrained patient begins to yell at you.Rationale: Only use the force necessary to initially restrain a patient.
Slide 104-

Review Upon arrival at the residence of a young male with an apparent emotional crisis, a police officer tells you that the man is acting bizarre. You find him sitting on his couch; he is conscious, but confused. He takes medications, but cannot remember why. His skin is pale and diaphoretic, and he has noticeable tremors to his hands. You should FIRST rule out: hypoglycemia. suicidal thoughts. severe depression. schizophrenia.
Slide 105-

Review Answer: A Rationale: There are numerous physical problems that can cause bizarre behavior, such as hypo-glycemia, hypoxemia, and brain tumors, among others. The EMT should rule out an underlying medical cause first. The patient’s pallor, diaphoresis, and motor tremors suggest hypoglycemia. The EMT should assess the patient’s blood glucose level, if trained to do so, and consider administering oral glucose. Psychiatric illnesses, such as clinical depression and schizophrenia, cannot be ruled in or out in the field.
Slide 106-

Review (1 of 2) Upon arrival at the residence of a young male with an apparent emotional crisis, a police officer tells you that the man is acting bizarre. You find him sitting on his couch; he is conscious, but confused. He takes medications, but cannot remember why. His skin is pale and diaphoretic, and he has noticeable tremors to his hands. You should FIRST rule out: hypoglycemia.Rationale: Correct answer suicidal thoughts. Rationale: This is a symptom, something that the patient tells you. It does not produce visible signs.
Slide 107-

Review (2 of 2) Upon arrival at the residence of a young male with an apparent emotional crisis, a police officer tells you that the man is acting bizarre. You find him sitting on his couch; he is conscious, but confused. He takes medications, but cannot remember why. His skin is pale and diaphoretic, and he has noticeable tremors to his hands. You should FIRST rule out: severe depression. Rationale: This cannot be ruled out in the prehospital setting. schizophrenia. Rationale: Schizophrenia cannot be ruled out in the field.
Slide 108-

Review Which of the following signs is LEAST indicative of a patient’s potential for violence? The patient appears tense and “edgy.” The patient is 6'5" tall and weighs 230 lb. The patient is loud and shouting obscenities. The patient is facing you with clenched fists.
Slide 109-

Review Answer: B Rationale: When assessing a patient’s potential for violence, you should observe for suggestive physical activity, such as clenching of the fists; glaring eyes; shouting obscenities; and rapid, disorganized speech. There is no correlation between a patient’s physical size and his or her potential for violence.
Slide 110-

Review (1 of 2) Which of the following signs is LEAST indicative of a patient’s potential for violence? The patient appears tense and “edgy.”Rationale: This is a signal of possible physical aggression and anger. The patient is 6'5" tall and weighs 230 lb.Rationale: Correct answer
Slide 112-

Review (2 of 2) Which of the following signs is LEAST indicative of a patient’s potential for violence? The patient is loud and shouting obscenities.Rationale: This is a signal of possible physical aggression and anger. The patient is facing you with clenched fists.Rationale: This is a signal of possible physical aggression and anger.