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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 23

Behavioral Health Emergencies

Learning objectives (14)

  1. Define excited delirium or agitated delirium — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  2. Describe methods used to restrain patients — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  3. Discuss general factors that can cause alteration in a patient’s behavior — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  4. Discuss the medical and legal aspects of managing a behavioral health emergency — Knowledge/skills objective (print textbook, Chapter 23); confirm wording in your course copy.
  5. Discuss the myths and realities concerning behavioral health emergencies — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  6. Explain how to recognize the behavior of a patient at risk of suicide, including the management of such a patient — Knowledge/skills objective (print textbook, Chapter 23); confirm wording in your course copy.
  7. Explain special considerations for assessing and managing a behavioral crisis or behavioral health emergency — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  8. Explain the care for a patient with excited delirium — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  9. Explain the care for a psychotic patient — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  10. Know the main principles of care for the agitated, violent, or uncooperative patient — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  11. Know the main principles of how the mental health care system functions — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  12. Know the two basic categories of diagnosis that a mental health professional will use — Knowledge/skills objective (printed page 853); confirm wording in your course copy.
  13. Recognize issues specific to posttraumatic stress disorder (PTSD) and the returning combat veteran — Knowledge/skills objective (print textbook, Chapter 23); confirm wording in your course copy.
  14. Recognize the magnitude of mental health disorders in society — Knowledge/skills objective (printed page 853); confirm wording in your course copy.

Vocabulary (11)

Behavioral emergency
A situation in which a patient's behavior is unacceptable or intolerable to the patient, family, or community — often signaling underlying medical or psychiatric illness.
Suicidal ideation
Thoughts about, considering, or planning suicide; ranges from passive thoughts to active planning.
Psychosis
A loss of contact with reality — including hallucinations, delusions, or disorganized thinking.
Excited delirium
A severe agitation syndrome with hyperthermia, extreme strength, and combative behavior — a medical emergency with high mortality.
De-escalation
A set of verbal and nonverbal techniques used to calm an agitated person and reduce the risk of violence.
Therapeutic communication
Purposeful, supportive, and respectful interaction that builds trust and gathers accurate information from patients in distress.
Active listening
Attentive, non-judgmental focus on the speaker, with reflection and clarification rather than rebuttal.
Physical restraint
Use of devices or body positions to restrict movement; reserved for protection of the patient or others when other measures fail, and used per agency protocol.
Positional asphyxia
Airway or breathing compromise from a body position — especially prone restraint — that can cause death.
Suicide risk factors
Modifiable and non-modifiable conditions that increase suicide risk — prior attempts, mental illness, substance use, recent loss, access to lethal means.
Crisis intervention
Short-term immediate help that stabilizes a person experiencing a behavioral crisis and links them to definitive care.

Sequence practice (2 puzzles on Quiz Me)

De-escalation of an agitated patient

Order the EMT actions to verbally de-escalate a behavioral emergency.

  1. Ensure scene safety; maintain a clear exit and request law enforcement if needed
  2. Approach calmly with a low, steady voice and respectful distance
  3. Listen actively; acknowledge the patient's feelings without judgment
  4. Offer choices and clear, simple options
  5. Set limits respectfully; restate them if needed
  6. Move toward transport once rapport is established
Behavioral emergency scene safety priorities

Order the EMT's scene-safety priorities at a behavioral call.

  1. Stage at a safe distance until the scene is secured if violence is reported
  2. Coordinate with law enforcement to enter when safe
  3. Visually scan for weapons or environmental hazards
  4. Maintain an unobstructed egress
  5. Move on to patient contact and de-escalation

Quick fire sample (11 of 11 on Quiz Me)

A situation in which a patient's behavior is unacceptable or intolerable to the patient, family, or community — often signaling underlying medical or psychiatric illness.
  1. Psychosis
  2. Active listening
  3. Behavioral emergency
  4. Physical restraint
Thoughts about, considering, or planning suicide; ranges from passive thoughts to active planning.
  1. Suicidal ideation
  2. Excited delirium
  3. Suicide risk factors
  4. Positional asphyxia
A loss of contact with reality — including hallucinations, delusions, or disorganized thinking.
  1. Suicide risk factors
  2. Positional asphyxia
  3. Psychosis
  4. Physical restraint
A severe agitation syndrome with hyperthermia, extreme strength, and combative behavior — a medical emergency with high mortality.
  1. Excited delirium
  2. Active listening
  3. Positional asphyxia
  4. Physical restraint
A set of verbal and nonverbal techniques used to calm an agitated person and reduce the risk of violence.
  1. Excited delirium
  2. Behavioral emergency
  3. Positional asphyxia
  4. De-escalation
Purposeful, supportive, and respectful interaction that builds trust and gathers accurate information from patients in distress.
  1. Behavioral emergency
  2. Therapeutic communication
  3. De-escalation
  4. Psychosis
Attentive, non-judgmental focus on the speaker, with reflection and clarification rather than rebuttal.
  1. Suicidal ideation
  2. Active listening
  3. Excited delirium
  4. De-escalation
Use of devices or body positions to restrict movement; reserved for protection of the patient or others when other measures fail, and used per agency protocol.
  1. Physical restraint
  2. Suicidal ideation
  3. Active listening
  4. Excited delirium
Airway or breathing compromise from a body position — especially prone restraint — that can cause death.
  1. De-escalation
  2. Positional asphyxia
  3. Psychosis
  4. Therapeutic communication
Modifiable and non-modifiable conditions that increase suicide risk — prior attempts, mental illness, substance use, recent loss, access to lethal means.
  1. Therapeutic communication
  2. Suicide risk factors
  3. Active listening
  4. Physical restraint
Short-term immediate help that stabilizes a person experiencing a behavioral crisis and links them to definitive care.
  1. Positional asphyxia
  2. Crisis intervention
  3. Therapeutic communication
  4. Suicide risk factors

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/23/print/. Answers are not marked on this sheet.