Psychological Behavioral Emergencies - Revision history

Treloars at 13:54, 24 April 2020

2020-04-24T13:54:53Z

← Older revision		Revision as of 13:54, 24 April 2020
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	Chemical Restraint		Chemical Restraint

	If verbal restraint is unsuccessful, and you have determined that the patient must be taken to a hospital without their informed consent then chemical restraint should be attempted. Chemical restraint is best used if a patient has already allowed an IV to be inserted. If attempting intranasal, be cautious of a patient biting or in other ways being physically aggressive. If IV or intranasal is not possible, attempt IM [[~~Sedative Hypnotics~~\|VALIUM]] or [[~~Sedative Hypnotics~~\|MIDAZOLAM]] (VERSED) in the anterior thigh, the upper outer quadrant of the buttocks, or the deltoid. **IM or IN injection of [[~~Sedative Hypnotics~~\|MIDAZOLAM]] (VERSED) requires immediate IV access upon sedation.		If verbal restraint is unsuccessful, and you have determined that the patient must be taken to a hospital without their informed consent then chemical restraint should be attempted. Chemical restraint is best used if a patient has already allowed an IV to be inserted. If attempting intranasal, be cautious of a patient biting or in other ways being physically aggressive. If IV or intranasal is not possible, attempt IM [[Valium\|VALIUM]] or [[Versed\|MIDAZOLAM]] (VERSED) in the anterior thigh, the upper outer quadrant of the buttocks, or the deltoid. **IM or IN injection of [[Versed\|MIDAZOLAM]] (VERSED) requires immediate IV access upon sedation.


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	* If applicable, consult law enforcement for assistance with transport of the unwilling patient.		* If applicable, consult law enforcement for assistance with transport of the unwilling patient.
	*If patient becomes severely agitated, to the point of interfering with patient care and / or becomes a physical danger to the crew’s well being, administer		*If patient becomes severely agitated, to the point of interfering with patient care and / or becomes a physical danger to the crew’s well being, administer
	** [[~~Sedative Hypnotics~~\|MIDAZOLAM]] (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or [[~~Sedative Hypnotics~~\|DIAZEPAM]] (VALIUM) 5-10 mg IV or IM.		** [[Versed\|MIDAZOLAM]] (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or [[Valium\|DIAZEPAM]] (VALIUM) 5-10 mg IV or IM.
	** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, [[~~Sedative Hypnotics~~\|DIAZEPAM]] (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg [[~~Sedative Hypnotics~~\|DIAZEPAM]] (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.		** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, [[Valium\|DIAZEPAM]] (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg [[Valium\|DIAZEPAM]] (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.

	[[Category:Medical\|0511]]		[[Category:Medical\|0511]]

Treloars at 02:15, 31 January 2018

2018-01-31T02:15:12Z

← Older revision		Revision as of 02:15, 31 January 2018
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	** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.		** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.

	[[Category:Medical]]		[[Category:Medical\|0511]]

Treloars: /* Section 5 -MEDICAL */

2012-04-02T01:45:06Z

Section 5 -MEDICAL

← Older revision		Revision as of 01:45, 2 April 2012
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	** [[Sedative Hypnotics\|MIDAZOLAM]] (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) 5-10 mg IV or IM.		** [[Sedative Hypnotics\|MIDAZOLAM]] (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) 5-10 mg IV or IM.
	** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.		** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.

			[[Category:Medical]]

Treloars: /* 5.11 PSYCHOLOGICAL / BEHAVIORAL EMERGENCIES */

2012-01-31T19:21:38Z

5.11 PSYCHOLOGICAL / BEHAVIORAL EMERGENCIES

← Older revision		Revision as of 19:21, 31 January 2012
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	Chemical Restraint		Chemical Restraint

	If verbal restraint is unsuccessful, and you have determined that the patient must be taken to a hospital without their informed consent then chemical restraint should be attempted. Chemical restraint is best used if a patient has already allowed an IV to be inserted. If attempting intranasal, be cautious of a patient biting or in other ways being physically aggressive. If IV or intranasal is not possible, attempt IM ~~Valium~~ or ~~Versed~~ in the anterior thigh, the upper outer quadrant of the buttocks, or the deltoid. **IM or IN injection of MIDAZOLAM (VERSED) requires immediate IV access upon sedation.		If verbal restraint is unsuccessful, and you have determined that the patient must be taken to a hospital without their informed consent then chemical restraint should be attempted. Chemical restraint is best used if a patient has already allowed an IV to be inserted. If attempting intranasal, be cautious of a patient biting or in other ways being physically aggressive. If IV or intranasal is not possible, attempt IM [[Sedative Hypnotics\|VALIUM]] or [[Sedative Hypnotics\|MIDAZOLAM]] (VERSED) in the anterior thigh, the upper outer quadrant of the buttocks, or the deltoid. **IM or IN injection of [[Sedative Hypnotics\|MIDAZOLAM]] (VERSED) requires immediate IV access upon sedation.


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	* If applicable, consult law enforcement for assistance with transport of the unwilling patient.		* If applicable, consult law enforcement for assistance with transport of the unwilling patient.
	*If patient becomes severely agitated, to the point of interfering with patient care and / or becomes a physical danger to the crew’s well being, administer		*If patient becomes severely agitated, to the point of interfering with patient care and / or becomes a physical danger to the crew’s well being, administer
	** MIDAZOLAM (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or DIAZEPAM (VALIUM) 5-10 mg IV or IM.		** [[Sedative Hypnotics\|MIDAZOLAM]] (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) 5-10 mg IV or IM.
	** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, DIAZEPAM (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg DIAZEPAM (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.		** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg [[Sedative Hypnotics\|DIAZEPAM]] (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.

Treloars at 16:35, 30 January 2012

2012-01-30T16:35:19Z

← Older revision		Revision as of 16:35, 30 January 2012
Line 26:		Line 26:

	If you are unable to verbally or chemically restrain the patient then physical restraint must be used. It is important to know that the least restrictive and least amount of time in physical restraints should be utilized.		If you are unable to verbally or chemically restrain the patient then physical restraint must be used. It is important to know that the least restrictive and least amount of time in physical restraints should be utilized.


	[[Initial Medical Assessment and Care\|INITIAL MEDICAL CARE]] (2.01).		[[Initial Medical Assessment and Care\|INITIAL MEDICAL CARE]] (2.01).
	* If applicable, consult law enforcement for assistance with transport of the unwilling patient.		* If applicable, consult law enforcement for assistance with transport of the unwilling patient.
			*If patient becomes severely agitated, to the point of interfering with patient care and / or becomes a physical danger to the crew’s well being, administer
	If patient becomes severely agitated, to the point of interfering with patient care and / or becomes a physical danger to the crew’s well being, administer		** MIDAZOLAM (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or DIAZEPAM (VALIUM) 5-10 mg IV or IM.
	* MIDAZOLAM (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or DIAZEPAM (VALIUM) 5-10 mg IV or IM.		** If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, DIAZEPAM (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg DIAZEPAM (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.
	* If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, DIAZEPAM (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg DIAZEPAM (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.

Treloars: Created page with "== Section 5 -MEDICAL== ===5.11 PSYCHOLOGICAL / BEHAVIORAL EMERGENCIES=== CONSIDER MEDICAL ETIOLOGY OF PSYCHOLOGICAL /BEHAVIORAL DISORDER AND REFER TO APPROPRIATE PRACTICE PA..."

2012-01-30T16:34:29Z

Created page with "== Section 5 -MEDICAL== ===5.11 PSYCHOLOGICAL / BEHAVIORAL EMERGENCIES=== CONSIDER MEDICAL ETIOLOGY OF PSYCHOLOGICAL /BEHAVIORAL DISORDER AND REFER TO APPROPRIATE PRACTICE PA..."

New page

== Section 5 -MEDICAL==
===5.11 PSYCHOLOGICAL / BEHAVIORAL EMERGENCIES===

CONSIDER MEDICAL ETIOLOGY OF PSYCHOLOGICAL /BEHAVIORAL DISORDER AND REFER TO APPROPRIATE PRACTICE PARAMETER:
* Hypoxia, [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01).
* Substance Abuse, [[Drug Overdose Poisoning|DRUG OVERDOSE / POISONING]] (5.05).
* Neurologic Disease, [[Suspected Stroke Transcient Ischemic Attack TIA|STROKE]] (5.04).
* Metabolic Derangements, [[Hypo or Hyperglycemia|HYPO / HYPERGLYCEMIA]] (5.10).

Establish SCENE AND PERSONAL SAFETY - Call law enforcement personnel to scene if needed.
Above all, DO NOTHING TO JEOPARDIZE YOUR OWN SAFETY.
* Determine and document if patient is a threat to self or others or if patient is unable to care or provide for self. Protect patient from harm to self or others.

Verbal Restraint

The EMS crew should attempt to calm, reassure, or reason with the patient. If the patient appears stable then these attempts should be repeated. If the patient appears unstable, agitated, or aggressive, then verbal restraint should be abandoned early.

Chemical Restraint

If verbal restraint is unsuccessful, and you have determined that the patient must be taken to a hospital without their informed consent then chemical restraint should be attempted. Chemical restraint is best used if a patient has already allowed an IV to be inserted. If attempting intranasal, be cautious of a patient biting or in other ways being physically aggressive. If IV or intranasal is not possible, attempt IM Valium or Versed in the anterior thigh, the upper outer quadrant of the buttocks, or the deltoid. **IM or IN injection of MIDAZOLAM (VERSED) requires immediate IV access upon sedation.

Physical Restraint

If you are unable to verbally or chemically restrain the patient then physical restraint must be used. It is important to know that the least restrictive and least amount of time in physical restraints should be utilized.

[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01).
* If applicable, consult law enforcement for assistance with transport of the unwilling patient.

If patient becomes severely agitated, to the point of interfering with patient care and / or becomes a physical danger to the crew’s well being, administer
* MIDAZOLAM (VERSED) 2 – 5 mg IVP or IO or .07-.08 mg/kg IM or 5 mg IN, or DIAZEPAM (VALIUM) 5-10 mg IV or IM.
* If patient is experiencing ACUTE ALCOHOL WITHDRAWAL, DIAZEPAM (VALIUM) 2 - 20 mg Slow IVP for adults, titrated to effect. If no IV access, administer 10 - 20 mg DIAZEPAM (VALIUM) IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.