Psychiatric Crisis Assessment
This part of your assessment will help you determine if the patient is having an acute episode of a psychiatric emergency
What is SAMPLE?
This is the top priority in managing a violent or psychotic patient in the prehospital ALS setting before administering medications.
What is scene safety and provider safety?
This disorder is characterized by sudden, usually unexpected, and overwhelming feelings of fear and dread.
What is a Panic Disorder?
This commonly abused drug known is known to give patients a feeling of bugs crawling on their skin when abused
What is Methamphetamine?
When a patient experiencing a psychiatric emergency is unconscious or unable to make decisions, and no legal guardian is present, a paramedic may treat under this legal doctrine.
When a patient becomes a danger to themselves or others, this intervention may be used alongside chemical sedation and requires proper positioning and continuous reassessment.
What are physical restraints?
Patients with this mood disorder are at high risk for suicide and must be evaluated for intent to harm themselves
What is depression?
You respond to a 39-year-old with schizophrenia who is hearing voices but is calm, cooperative, and not a danger to self or others. This is your most appropriate ALS approach.
What is verbal de-escalation?
Family history, social isolation, alcohol abuse, and depression are risk factors for what?
What is suicide?
This condition is characterized by the following symptoms after consuming drugs - hallucinations, delusions, and impaired cognition
What is drug indued psychosis?
A paramedic responds to a 17-year-old with a known history of bipolar disorder who is threatening self-harm and refusing transport. The parents are on scene and consenting, but the patient is resistive. With this form, the paramedic can transport this patient to the hospital for a psychiatric evaluation despite refusing transport
What is a 5150 hold?
After administering sedatives for agitation, this monitoring tool is the most reliable for detecting early hypoventilation, even before oxygen saturation drops.
What is capnography (ETCO₂ )?
This mnemonic is used for mental status examination for psychiatric patients and is a key part of your assessment
What is COASTMAP?
A violently agitated patient requires both physical restraints and sedation. This is the key physiological parameter you must continuously monitor after sedation.
What is airway and respiratory status?
This patient believes there is nothing wrong and feels on top of the world. Bystander or family member usually calls for EMS assistance.
What is Mania or Manic Episode?
An overdose of stimulants such as methamphetamine can cause this psychiatric emergency
What is excited delirium?
This is the percentage of the US population that is diagnosed with some form a psychological/behavior disorder
What is 20%?
Before labeling a patient as purely psychiatric, ALS providers must identify and treat these reversible conditions such as hypoxia, hypoglycemia, or overdose.
What are underlying medical causes?
Hypoxia, seizure, TBI, Parkinsons/alzheimers, infection(meningitis) and brain tumors are all part of this category for what may be an underlying cause of abnormal behavior that should be assessed
What is organic or biologic causes of abnormal behavior?
This condition must be considered in agitated patients with hyperthermia, tachycardia, and extreme strength, and can quickly become fatal.
What is excited delirium?
Dysthymic disorder is characterized as a person having this for most days and for over 2 years.
What is Persistent Depressive Disorder?
This syndrome is another name of an overdose characterized by agitation confusion high fever and elevated serotonin levels
What is serotonin syndrome?
A paramedic responds to a psychiatric emergency involving a 70-year-old patient with dementia who is agitated and combative. The patient lacks capacity to refuse care. This legal framework, separate from implied consent, is often already in place for elderly.
What is a (Healthcare) Power of Attorney?
This benzodiazepine is commonly used for acute agitation in the field, works by enhancing GABA activity. Include dose and route.
What is Midazolam (Versed)? 2–5 mg IV/IM or 5–10 mg IM