Exam 26: Behavioral Emergencies

You are responding to a patient with a behavioral problem. While en route, dispatch contacts you and states that there is a mental-health delegate at the scene and you will be transporting the patient to the local psych hospital for treatment of her bipolar disorder. On scene which one of the following patient behaviors should help confirm that the patient is suffering from bipolar disorder?

A patient states that she cannot leave the house to go to the hospital "because I am scared I will do something idiotic and lose it and then everyone will look at me and laugh." She states she rarely leaves the house and the last time she did, she began to hyperventilate. This caused her to return home immediately. Based on this information, the EMT should recognize the patient as suffering from:

You are on a scene with a patient who up until a few seconds ago was calm and compliant. Now he is brandishing a knife and threatening to kill you and your partner if you do not immediately leave. The man is intoxicated and police have been notified but have not yet arrived. Which one of the following is your best course of action?

Which of the following patients would the EMT classify as having a behavioral emergency?

You arrive on scene to find that the police have subdued a violent man with a history of behavioral problems. They state they will put the patient on the stretcher. Which one of the following should cause the EMT to take immediate and corrective action?

According to family, a 24-year-old female suddenly began to act in a hostile manner. After assessing her, you determine that she cannot remember her name or present location and is drooling. Based on these findings, you should suspect a:

An EMT is transporting a restrained patient who is trying to spit on him. Which one of the following would the EMT be justified in doing?

You are called by a husband who states that his wife is bipolar and in need of help at the hospital. Which presentation would make the most sense related to this disorder?

Which one of the following patients is the EMT justified in restraining?

After taking a patient to the hospital for an unsuccessful suicide attempt, your partner states that this is the fifth suicide call he has had this month. Four of them have been women who were unsuccessful and the fifth was a man who shot himself in the head and was dead on the scene. Which one of the following responses is most accurate?

You are responding to a home for injuries resulting from a domestic altercation. In preparation for patient contact, what would you tell your partner?

Which one of the following statements shows that the EMT has a good understanding of dealing with a behavioral emergency patient?

During transport, a female patient who is restrained begins to cry and states that she is sorry for becoming violent and will not behave in that manner anymore. She requests that the restraints be removed because they are hurting her legs and she does not wish to be restrained any longer. After ensuring that the restraints are not too tight and not harming the extremities, you would:

While transporting a patient with schizophrenia, he suddenly screams, "Do you see that snake? It is right next to you! Kill it!" How should you respond to this patient?

A male patient with a history of behavioral problems continually smacks his lips, sticks his tongue out, and turns his head to the left. His arm also jerks upward regularly. Which statement, made by a caregiver, would an EMT recognize as most important and relating to this presentation?

You have been dispatched to transfer a patient with schizophrenia from a hospital emergency department to a behavioral health unit at another hospital. While en route, your partner states that he cannot remember what schizophrenia is. You should tell him that schizophrenia is a behavioral disorder commonly characterized by:

Bystanders called 911 for a female patient who was screaming obscenities in a store parking lot. On arrival you find the patient to be sitting in the middle of the parking lot muttering incomprehensible phrases. After conducting the primary assessment and finding no immediate life-threatening conditions, you move her to the ambulance. Additional assessment findings include abrasions to her arm and urinary and fecal incontinence. She also has a bottle of Prozac in her pocket. You reference Prozac in your medication book and find it to be used to treat depression. With this information, how will you treat this patient?

Given the research related to suicide, which one of the following patients should the EMT recognize as the highest risk for a suicidal action?

The EMT would recognize a patient as having a phobia when he makes what statement?

You are on the scene of a male patient who threatened to take pills to end his life. In talking with the patient, he informs you that he just got a new job that requires more of his time and his wife has been giving him a hard time about it. Tonight, he had enough and just made the comment because he was mad at her. He says that although he is still upset, he doesn't plan to do anything drastic. Before taking further action, which one of the following facts about the patient should raise the EMT's suspicion that he is indeed at a higher risk for suicide?