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Neurosis vs Psychosis… Neurosis Person exhibits abnormal behavior, but remains able to understand the normal boundaries of reality Ex. Anxiety Depression Paranoia agitation Psychosis Person exhibits abnormal behavior, and has altered perceptions of reality Ex. Schizophrenia Bipolar disorder
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Behavioral EmergenciesChapter 33
Guillermo De La Renta
OK so…
Behavior….
• An individuals action or reaction in response to external or internal stimuli• Can be normal or
abnormal (subjective)
Behavioral emergency….
• A form of altered mental status• Behavior abnormal
within the context of the situation• Variety of causes
Neurosis vs Psychosis…
Neurosis
• Person exhibits abnormal behavior, but remains able to understand the normal boundaries of reality
Ex. • Anxiety• Depression• Paranoia• agitation
Psychosis • Person exhibits
abnormal behavior, and has altered perceptions of reality• Ex.• Schizophrenia• Bipolar disorder
Causes of behavioral emergencies
• Medical disorders• AMS possible NOI• Underlying issue often hypoxia, hypoglycemia• Ex. Epilepsy, hypotension, diabetes…
• Chemical exposures• Alcohol, drugs• Frequent cause of BE• Prescription or recreational (ex. Insulin vs. alcohol)
• Trauma• Brain injuries cause AMS and behavioral disorders
• TBI wide range of symptoms• Blood loss hypoxia in brain• Hypo and hyperthermia brain is pissed
• Behavioral conditions• Your psyche is complex • I.e. psychiatric s%&*
Signs and symptoms• Agitation• Paranoia• Stress-laden speech• Bizarre actions or
thoughts• Self-destructive behavior• Mental confusion• Hostility• Uncontrolled (scream)
crying
Assessment and Treatment
Assessment
• Scene safety BEs can escalate • (0 100, real quickly)
• Consider possible contexts• Try to notice subtle
behaviors• Don’t forget about basic
documentation and assessment (SAMPLE, oprst, vitals…)
Management
• Preventative • Keep patient and rescuers
safe• Supportive • Correct potential threats to
life• Assume behavior is from
medical condition treat accordingly
Restraint
Indications
• When patient is endangering self or others
How-to!
• Best done by LEO
• Reasonable force
• Ideally, minimum 5 people