FISDAP MEDICAL EMERGENCIES STUDYS ALL
ANSWERS AND QUESTIONS SET A+
✔✔psychosis - ✔✔a mental disorder characterized by the loss of contact with reality.
patients may be belligerent and angry towards others, or silent and withdrawn.
caused by substances, severe stress, delusional disorders, schizophrenia. some
psychotic episodes last for brief periods, others a lifetime.
Includes schizophrenia.
approach and treat these patients as you would with a behavioral crisis.
✔✔excited delirium - ✔✔a serious behavioral condition in which a person exhibits
agitated behavior combined with disorientation, hallucinations, or delusions; also called
agitated delirium or exhaustive mania.
generally not dangerous, but may strike out spontaneously.
hypertension, tachycardia, diaphoresis, dilated pupils. agitation is a biologic attempt to
release nervous tension and can produce sudden, unpredictable physical actions.
Treat and interview like a behavioral crisis patient. do not discount the possibility of
substance, trauma, or physiological illness you need to treat.
if agitation continues, request ALS for chemical restraint. uncontrolled agitation can lead
to sudden cardiopulmonary arrest, metabolic acidosis, and or sudden death. use of
tasers, stimulant drugs, or physical restraints can contribute to sudden death in these
patients. positional asphyxia can also occure.
✔✔delirium - ✔✔sudden change in mental status that is generally acute and reversible,
characterized by disorientation, inability to focus, inattention, inability to think logically,
memory loss, striking changes in personality and affect, hallucinations, delusions, or
decreased LOC
, ✔✔agitation - ✔✔a behavior characterized by restless and irregular physical acitivity.
✔✔Restraints and risks - ✔✔the method of restraint chosen should be the least
restrictive method that will ensure safety fo the patient and providers.
improperly applied restrains can cause positional asphyxia, aspiration, severe acidosis,
and sudden cardiac death.
always have permission from medical control to avoid charges of assault, batter, false
imprisonment, and or violation of civil rights. Only use restraints to protect yourself or
others from bodily harm (including the patients).
always involve law enforcement when restraints are involved -- behavioral
crisis/psychiatric emergency, always call them.
a patient who is retrained by law enforcement is in their custody.
make a significant effort at verbal descalation to try to avoid the need of a restrained.
consider asking family and friends for help. The safest is to avoid physical contact if at
all possible.
✔✔position asphyxia - ✔✔restriction of chest wall movements and/or airway
obstruction; can rapidly lead to sudden death.
✔✔restraint process - ✔✔5 people carry out the restraint (each limb and the head), and
1 team leader. have a plan of action. use minimum force. avoid acts of physical force
that might injure the patient.
someone should talk the patient throughout the process, treat the patient with dignity
and respect regardless, same gender EMS should attend if at all possible, wear
appropriate PPE, avoid direct eye contact and respect the patient's personal space,
never leave a restrained patient unattended.
physically uncooperative patients should be restrained in the lateral decubitus position
(one arm above the head, other below the waist, four point restrains (arms and legs) are
preferred. restraining hips, thighs, and chest inhibits movement
two point is also an option: one arm is upward toward the head and the other is toward
the waist.
restraining thighs just above the knees prevents kicking and is more effective than ankle
restraints. do not place anything over face, head, or neck.
if patient is spitting, a surgical mask may be placed loosely over the mouth. if patient
tries to bite, a hard cervical collar may be placed on the neck.
ANSWERS AND QUESTIONS SET A+
✔✔psychosis - ✔✔a mental disorder characterized by the loss of contact with reality.
patients may be belligerent and angry towards others, or silent and withdrawn.
caused by substances, severe stress, delusional disorders, schizophrenia. some
psychotic episodes last for brief periods, others a lifetime.
Includes schizophrenia.
approach and treat these patients as you would with a behavioral crisis.
✔✔excited delirium - ✔✔a serious behavioral condition in which a person exhibits
agitated behavior combined with disorientation, hallucinations, or delusions; also called
agitated delirium or exhaustive mania.
generally not dangerous, but may strike out spontaneously.
hypertension, tachycardia, diaphoresis, dilated pupils. agitation is a biologic attempt to
release nervous tension and can produce sudden, unpredictable physical actions.
Treat and interview like a behavioral crisis patient. do not discount the possibility of
substance, trauma, or physiological illness you need to treat.
if agitation continues, request ALS for chemical restraint. uncontrolled agitation can lead
to sudden cardiopulmonary arrest, metabolic acidosis, and or sudden death. use of
tasers, stimulant drugs, or physical restraints can contribute to sudden death in these
patients. positional asphyxia can also occure.
✔✔delirium - ✔✔sudden change in mental status that is generally acute and reversible,
characterized by disorientation, inability to focus, inattention, inability to think logically,
memory loss, striking changes in personality and affect, hallucinations, delusions, or
decreased LOC
, ✔✔agitation - ✔✔a behavior characterized by restless and irregular physical acitivity.
✔✔Restraints and risks - ✔✔the method of restraint chosen should be the least
restrictive method that will ensure safety fo the patient and providers.
improperly applied restrains can cause positional asphyxia, aspiration, severe acidosis,
and sudden cardiac death.
always have permission from medical control to avoid charges of assault, batter, false
imprisonment, and or violation of civil rights. Only use restraints to protect yourself or
others from bodily harm (including the patients).
always involve law enforcement when restraints are involved -- behavioral
crisis/psychiatric emergency, always call them.
a patient who is retrained by law enforcement is in their custody.
make a significant effort at verbal descalation to try to avoid the need of a restrained.
consider asking family and friends for help. The safest is to avoid physical contact if at
all possible.
✔✔position asphyxia - ✔✔restriction of chest wall movements and/or airway
obstruction; can rapidly lead to sudden death.
✔✔restraint process - ✔✔5 people carry out the restraint (each limb and the head), and
1 team leader. have a plan of action. use minimum force. avoid acts of physical force
that might injure the patient.
someone should talk the patient throughout the process, treat the patient with dignity
and respect regardless, same gender EMS should attend if at all possible, wear
appropriate PPE, avoid direct eye contact and respect the patient's personal space,
never leave a restrained patient unattended.
physically uncooperative patients should be restrained in the lateral decubitus position
(one arm above the head, other below the waist, four point restrains (arms and legs) are
preferred. restraining hips, thighs, and chest inhibits movement
two point is also an option: one arm is upward toward the head and the other is toward
the waist.
restraining thighs just above the knees prevents kicking and is more effective than ankle
restraints. do not place anything over face, head, or neck.
if patient is spitting, a surgical mask may be placed loosely over the mouth. if patient
tries to bite, a hard cervical collar may be placed on the neck.
