Psychiatric/Behavioral Emergency

Inclusion Criteria: Patients exhibiting psychological disturbances that produce thoughts, feelings, and behaviors destructive to the patient or another person. Medics must report all patients with suspected suicide attempt or ideation to BioTel before leaving the scene. Treat patients suspected of taking an overdose using the Poisoned Patient and Overdose guidelines. Treat patients with an altered level of consciousness using the Altered Level of Consciousness guidelines.

NOTE: Consider alternative explanations for seemingly psychiatric or behavioral symptoms. (A-E-I-O-U-T-I-P-S; alcohol, epilepsy, insulin, overdose, underdose, trauma, infection, psychosis, sepsis.)

           Basic Level

1. Assess and support ABCs.
   
   
2. Position of comfort.
   
   
3. Reduce stimuli by isolating the patient from people or events causing his or her agitation.
   
   
4. Administer oxygen, as needed to maintain a SpO2 of at least 96%.
   
   
5. If the patient requires restraint, follow the Restraint of Patient Medical Policy.
   
   
6. If the patient exhibits any seizure activity, proceed to the Seizure guidelines.
   
   
   Advanced Level
   
   
7. Consider ECG and EtCO2 monitor.
   
   
8. Consider establishing IV access at a TKO rate or use a saline lock.
   Monitor vital signs during transport. Contact BioTel for destination advice for adolescent and pediatric patients.
   
   
9. If excited delirium suspected, see Altered Level of Consciousness guidelines.
   
   
10. For additional patient care considerations not covered under standing orders, consult BioTel.
    

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