Lecture Mosby's paramedic textbook (4th ed) - Chapter 35: Behavioral and psychiatric disorders

9/11/2012 1 Chapter 35 Behavioral and Psychiatric Disorders 2 Learning Objectives • Define what constitutes a behavioral emergency. • Identify potential causes for behavioral and psychiatric illnesses. • List three critical principles that should be considered in the prehospital care of any patient with a behavioral emergency. 3 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 1 9/11/2012 Learning Objectives • Outline key elements in the prehospital patient examination during a behavioral emergency. • Describe effective techniques for interviewing a patient during a behavioral emergency. • Distinguish between key symptoms and management techniques for selected behavioral and psychiatric disorders. 4 Learning Objectives • Identify factors that must be considered when assessing suicide risk. • Formulate appropriate interview questions to determine suicidal intent. • Explain prehospital management techniques for the patient who has attempted suicide. 5 Learning Objectives • Describe assessment of the potentially violent patient. • Outline measures that may be used in an attempt to safely diffuse a potentially violent patient situation. • List situations when patient restraints can be used. 6 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 2 9/11/2012 Learning Objectives • Discuss key principles in patient restraint. • Describe safety measures taken when patient violence is anticipated. • Explain variations in approach to behavioral emergencies in children. 7 Understanding Behavioral Emergencies • An estimated 26.2 percent of Americans age 18 and older suffer from diagnosable mental disorder in given year – About 57.7 million people • National Institute of Mental Health has estimated that 1 in 7 individuals will need treatment at some point in life for emotional disturbance – Mental health problems are leading cause of disability in U.S. and Canada for people 15 to 44 years of age 8 Understanding Behavioral Emergencies • No clear agreement or ideal model for “normal” behavior • Considered to be adaptive behavior accepted by society – Can vary by culture and ethnic group – Concept of “abnormal” (maladaptive) behavior also is defined by society when behavior • Deviates from society’s norms and expectations • Interferes with well‐being and ability to function • Harms individual or group 9 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 3 9/11/2012 Can you think of a time in your life when you, a family member, or a close friend had a behavior that fit this definition? How did it make you feel? 10 Understanding Behavioral Emergencies • Behavioral emergency – Change in mood or behavior that cannot be tolerated by involved person or others – Requires immediate attention – May range from brief inability to cope with stress or anxiety to situations in which patients may be dangerous to themselves and others – Most people with mental illness function well on daily basis 11 Understanding Behavioral Emergencies • Depression, anxiety disorders, mild personality disorders often are effectively managed with medication and counseling in outpatient mental health centers • Most behavioral emergencies have a biological/organic, psychosocial, or sociocultural cause 12 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 4 9/11/2012 13 Biological Causes • Physical or biochemical disturbances in brain can result in significant changes in behavior • Biological disturbances – Mental disorders that result from physical rather than a purely psychological cause 14 Biological Causes • Examples of biological causes – Genetic factors – Prenatal and postnatal factors • Infection • Endocrine, metabolic, vascular disorders – Imbalance in brain chemistry (may have heritable component) – Alterations in neurotransmission 15 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 5 ... - tailieumienphi.vn