Interactive Ready for Review: Interactivities

Behavioral emergencies can present the EMT-I with great difficulties in patient management. Your major responsibility in these situations is to defuse potentially life-threatening incidents and reduce the impact of the stressful condition without exposing yourself to unnecessary risks.

While only a small percentage of people with mental health disorders are dangerous to themselves or others, you may be exposed to a higher proportion of violent situations in your daily activities. There are a number of warning signs of , including a history of hostile behavior, rigidity, loud and erratic speech patterns, agitation, and depression.

A behavioral emergency is any reaction to events that interferes with the ADL. A person who is no longer able to respond appropriately to the environment may be having a more serious psychiatric emergency. Not all behavioral emergencies involve , however. Some emergencies are a temporary response to a traumatic event.

Underlying causes of behavioral emergencies fall into two categories: organic and disorders.

Assessing a person who may be having a behavioral crisis involves observing the person, talking with the person, and talking with friends, family members, and witnesses to the person's behavior. You are looking for indications that the person's thoughts, feelings, and reactions are inappropriate for the circumstances. Remember to always assess ABCs.

Consider contributing factors in four areas: central nervous system dysfunction, environmental factors or clues, drug or alcohol use, and circumstances such as the death of a loved one or other major interruption of normal life.

The threat of suicide requires immediate intervention. is the most significant risk factor for suicide. Others include personal or family history of suicide attempts, chronic debilitating illness, financial setback, and severe mental illness.

As an EMT-I, you have limited legal authority to require a patient to undergo emergency medical care in the absence of a life-threatening emergency. Most states have provisions allowing law enforcement personnel to place mentally impaired persons in custody so that such care can be provided. You should always involve law enforcement personnel any time you are called to assist a patient with a severe behavioral or psychiatric crisis.

Always consult medical control and contact law enforcement for help before restraining a patient. If there is an immediate threat, leave the area until law enforcement secures the scene. If restraints are required, use the minimum force necessary. Assess the airway and circulation frequently while the patient is restrained, and maintain a constant dialogue with the patient throughout the restraining process.

In providing emergency medical care for a patient having a behavioral emergency, be direct, honest, and calm; have a definitive plan of action; stay with the patient at all times, but do not get too close; express interest in the patient's story, but do not judge his or her behavior. Always treat patients with respect.