Chapter 23: Behavioral Health Emergencies

Key Topics

• Recognition of Risk Behaviors

  • Importance for EMTs to recognize behaviors posing risks
  • Focus on protecting the EMT, patient, and others

• Principles of Mental Health

  • Understanding emotional crises vs. mental illness
  • Misconceptions about depression and mental illness

Mental Health System

• Acute Situations

  • Psychosis, suicidal risk, agitated delirium
  • Increase in mental health emergencies in EMT careers

• Causes of Behavioral Crises

  • Mental illness, substances, stress
  • Emotional crises are not the same as mental illnesses

• Common Misconceptions

  • Not all with mental health disorders are dangerous
  • Depression as a normal life event

Managing Behavioral Health Emergencies

• Communication Skills

  • Recognizing signs of potential violence
  • Importance of communication and safety

• Behavioral Crisis Characteristics

  • Agitated, violent, or uncooperative behavior
  • Danger to self or others

• Mental Health Disorders

  • Common disorders: anxiety, PTSD, OCD, etc.

• Assessment and Management

  • Outpatient vs. Inpatient care
  • Underlying causes like social stress, diseases, chemical problems

EMT Roles and Responsibilities

• Scene Safety

  • Constant assessment of scene safety
  • Involvement of law enforcement if necessary

• Patient Assessment

  • General impression from a distance
  • Detailed physical exam and patient rapport

• Transport and Intervention

  • Importance of patient comfort
  • Spending adequate time with behavioral patients

• Documentation and Communication

  • Thorough documentation, especially with restraints

Recognizing and Responding to Disorders

• Psychosis and Schizophrenia

  • Delusions, hallucinations, and lack of pleasure
  • Guidelines for handling psychotic patients

• Excited Delirium

  • Disorientation, hyperactivity, hallucinations
  • Strategy for approaching patients calmly

Legal and Ethical Considerations

• Consent and Competency

  • Implied consent for those unable to grant it
  • Legal implications of restraining without authority

• Handling Violent Patients

  • Using minimum force necessary
  • Documentation of restraint processes

Suicide and PTSD

• Risk Factors for Suicide

  • Depression, loss, substance abuse, etc.

• Symptoms and Management of PTSD

  • Feelings of helplessness, anxiety, fear
  • Specialized care for combat veterans

Practice Questions and Scenarios

• Review common scenarios EMTs may face
• Importance of scene safety and patient communication

Conclusion

• Behavioral health emergencies are complex and require careful handling by EMTs.
• Prioritizing safety, communication, and thorough assessment can help manage these situations effectively.