emt-basic curriculum module 4

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State of WisconsinEMT-Basic: A Practice BasedApproach to EMS Educationof mental illness or the use of mind altering substances.Restraints are the best LAST option in a behavioralemergency.Prerequisites:AV Equipment:EMS Equipment:Primary Instructor:Assistant Instructor:BLS, Preparatory, Airway and Patient Assessment.MATERIALSUtilize various audio-visual materials relating tobehavioral emergencies. The continuous design anddevelopment of new audio-visual materials relating toEMS requires careful review to determine which bestmeet the needs of the program. Materials should beedited to assure meeting the objectives of the <strong>curriculum</strong>.Stretcher, restraints.PERSONNELOne EMT-Basic instructor knowledgeable in behavioralemergencies.None required.PRESENTATIONDeclarative (What)I. BehaviorA. Behavior - manner in which a person acts or performs; any or allactivities of a person, including physical and mental activityB. Behavioral Emergency - a situation where the patient exhibitsabnormal behavior within a given situation that is unacceptable orintolerable to the patient, family or community. This behavior can bedue to extremes of emotion leading to violence or other inappropriatebehavior or due to a psychological or physical condition such as lack ofoxygen or low blood sugar in diabetes.II. Behavioral ChangeA. General factors that may alter a patient's behavior - the number offactors which may alter a patient's behavior include situationalstresses, medical illnesses, psychiatric problems and alcohol or drugs.Below is a list of common causes for behavior alteration.1. Low blood sugar2. Lack of oxygen3. Inadequate blood flow to the brain4. Head trauma5. Mind altering substancesModule 4-84
State of WisconsinEMT-Basic: A Practice BasedApproach to EMS Education6. Psychogenic - resulting in psychotic thinking, depression orpanic7. Excessive cold8. Excessive heatIII. Psychologic CrisesA. PanicB. AgitationC. Bizarre thinking and behaviorD. Danger to self - self destructive behavior, suicideE. Danger to others - threatening behavior, violenceIV. Assessment for Suicide RiskA. Depression1. Sad, tearful2. Thoughts of death or taking one's lifeB. Suicidal gestures - the EMT-Basic must recognize and intervene inself-destructive behavior before the patient commits the act of suicide.Risk factors may include:1. Individuals over 40, single, widowed or divorced, alcoholic,depressed2. A defined lethal plan of action which has been verbalized3. Unusual gathering of articles which can cause death such aspurchase of a gun, large volumes of pills, etc.4. Previous history of self-destructive behavior5. Recent diagnosis of serious illness6. Recent loss of significant loved one7. Arrest, imprisonment, loss of jobC. Assessment findings1. Patient in an unsafe environment or with unsafe objects inhands2. Displaying of self-destructive behavior during initial assessmentor prior to emergency response3. Important questions to be considereda) How does the patient feelb) Determine suicidal tendenciesc) Is patient a threat to self or othersd) Is there a medical probleme) InterventionsD. Emergency medical care1. Scene size-up, personal safety2. Patient assessment3. Calm the patient - do not leave patient alone4. Restrain if necessary. Consider need for law enforcement5. Transport6. If overdose, bring medications or drugs found to medical facilityV. Medical/Legal ConsiderationsModule 4-85
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