Behavioral Emergencies
Policy Schmolicy!
Paging Dr Beat-Emergency
Not on My Watch
Tied to Protocol
100
My patient's behavior is becoming increasingly agitated and I need help de-escalating the situation so I activate this emergency response.
What is BEST (Behavioral Emergency Response Team)?
100
The Rounding Nurse and a Respiratory Therapist Respond to this type of emergency call
RRT/Rapid Response
100
You call this resource at 6-0666 with a clinical question or concern
Who is the Rounding Nurse (704-4460-0666)
Message via Rover to CMC Rounding Nurse
100
This is the exact amount of treatment to give a hypoglycemia patient who is alert.
What is 15 grams of carbohydrates?
100
This is not considered a restraint if used by patient request, the patient is sedated/comatose/paralyzed/unresponsive, or the patient is temporarily on a stretcher for transport
What are 4 side rails? 
200
You use this phone number to activate a BEST (behavioral emergency response team).
What is 5-3333 (704-355-3333)?
200
ICU nurses, Doctors/APPs, Respiratory Therapists, Security, and Spiritual Care arrive to these type of emergency calls.
What is a Code Blue?
Nurses- MICU Rounding nurses, DHU nurse, MICU Charge nurse
Doctors- medical residents, ICU attending
Respiratory Therapists, Security, Spiritual Care, House Supervisor
200
You call this number to activate a Code Blue if the Code Blue button is not available or in the area
What is 5-2345 (704-355-2345)
200
These are the items I remove from the code cart and bring in the room during a cardiac arrest
What are the defibrillator, pads, the BVM, and the backboard?
200
This is only considered a restraint when pinned to the bedding, used with a wrist restraint, or when applied so tightly that the patient's hands/fingers are immobilized
What are mitts?
300
My patient is unable to be de-escalated and is now verbally threatening to assault staff so I call this number and say this
What is Security, Security Aler, Threat of Violence, 704-355-3333
704-355-3333
300
These are 3 criteria for activating an adult RRT at CMC
300
Your patient just developed a right arm weakness and slurred speech that is new with your assessment. You call this number to activate in-house Code Stroke?
What is 5-2345 to call RRT?
300
You find an unresponsive patient who is pulseless and not breathing, these are the top 3 priorities
1. Activate Code Blue
2. Start compressions
3. Get the defibrillator and place pads on the patient
300
A patient is being violent and aggressive. I've called Public Safety/Security to assist in holding the patient down so I can give them an IM injection. I need to request this type of restraint order from the provider?
What is a Violent, Physical Hold?
400
After a behavioral emergency, the team places this symbol on the door so other staff are aware.
What is a Blue Star? 
400
After you activate a Rapid Response, these are 2 people you should call.
Who are the Rounding Nurse and Attending Provider?
Additionally, Charge Nurse to support the situation and other patients in your assignment.
RRT Policy CMC: "Additionally, we encourage our staff to call the Rounding Nurse at 704-446-0666 (6-0666) and notify the attending physician ASAP."
Rationale: Delays in RRT paging system, attending provider is not notified with RRT paging.
400
Your patient develops new, acute chest pain. You activate RRT and obtain 12 lead ECG. It reads ***Acute MI*** so the Rounding Nurse activates this process by paging the internal Rover team.
What is Code STEMI?
"For an in-house patient with complaints of chest pain call the rapid response team and prepare to obtain 12 lead ECG immediately."
The Rounding Nurse activates Code STEMI during the rapid response. (Internal Rover team activation)
400
This is a respiratory sign of impending cardiac arrest. If the patient is unresponsive with this sign, it is recommended to assume the patient is in cardiac arrest and begin CPR
What is agonal breathing?
Shallow gasps. Irregular pattern of breathing characterized by gasping, snorting, or gurgling. Indication of an emergency and impending cardiac arrest.
400
This is a device which can be used without a restraint order if the intent is to support the patient's body position so they can have greater freedom in the chair.
What is a Lap Belt?
500
The names for each of these restraints:
What are soft and hard restraints?
Either can be used for violent or non-violent patients. 