Behavioral Emergencies-Accurately Assess and Manage Patients in Crisis – Valerie Vestal

Salepage link: At HERE. Archive:

You introduce yourself to a patient. Within a very short amount of time, you are charged to establish a therapeutic relationship, help rule out medical conditions, accurately assess presenting symptoms and evaluate for appropriate disposition. That’s not always the easiest task…

You must have astute judgement and clinical skills to pull together the pieces. As the situation begins to unfold, it may become clearer and clearer that there is a Behavioral Emergency taking place. And a behavioral health bed may not be immediately available. Perhaps you work in the emergency department, on a med/surg floor or in a nursing home. Regardless of the setting, department or exact role, patients may present with or begin to demonstrate what can feel like just plain frightening symptoms.

Advancing your skills to feel confident safely managing your patient’s combined medical and psychiatric needs is an absolute necessity. Watch clinician Valerie R. Vestal, MSN, PMHNP-BC, to take away new and essential approaches for crisis intervention, ETOH withdrawals, aggressive/violent behaviors, threats of serious harm, de-escalation techniques…and more!

1. Examine the pharmacology behind the substances of abuse seen presently in practice.
2. Analyze how dementia and delirium will present differently.
3. Evaluate de-escalation techniques for a variety of violent patient behaviors.
4. Recognize the terminology used to refer to street drugs today.
5. Effectively screen and assess for substance use disorders.
6. Devise strategies to ensure your safety, while caring for an aggressive patient.
7. Explain predictors of suicide, when evaluating a patient’s risk.
8. Plan for a patient who threatens to harm himself or another. 

The Psychosocial Assessment

• Differential diagnosis
• Assess level of consciousness
• Quick identification of physical problems that can lead to psychiatric symptoms
• Immediate safety concerns/danger to self
• Panic/anxiety/agitation
• Techniques to bring calm

Psychotic Emergencies

• Schizophrenia
• Psychosis related to medical conditions – delirium, endocrine disorders, cardiovascular disorders, pulmonary disorders
• Dementia and Alzheimer’s disease

ETOH

• Intoxication
• Withdrawal – delirium tremens
• Acute stage – detoxification, medical interventions
• Stabilization stage

Drug Related Emergencies

• Cocaine
• Amphetamine
• PCP
• Hallucinogens
• LSD
• Opioids
• Acute management and stabilization

Violent and Aggressive Behaviors

• Self-destructive behaviors
• Self-mutilating behaviors
• Suicidal risk
• Predictors of suicide
• Suspecting a drug overdose
• Strategies for your own safety
• De-escalation techniques

Mood Disorder Emergencies

• Major depressive disorder
• Bipolar disorders – manic episodes

Trauma Emergencies

• Domestic violence survivor
• Rape survivor
• Acute stress reaction

Families in Crisis

• Children/adolescent needs
• Geriatric emergencies
• Crisis intervention – for individuals, couples, an entire family