Basic principles of mental problems. Things we tend to overlook
- Emotional injury is just as real as physical injury.
The do’s and don’ts of restraining people with mental issues
- Do not restrain a patient in a prone position.
- Do not hog tie or bobble restraint a patient.
- Restraining might require police authorization
- Never leave patient alone
- If no one can communicate with the patient and you believe that he might present a danger to himself, to you, to others, you must notify police
Important questions to ask when dealing with a suicidal patient.
- Are you having thought about killing yourself?
- Do you have a plan or have you been planning to end your life. If so, how would you do it.
- Do you have the drugs, gun, rope that you would use? Where is it right now?
- How likely do you think you are to carry out your plan?
When obtaining a mental status exam, what information can you get when a patient talks back to you?
When a patient talks back to you, you can listen to speech pattern for abnormalities, such as slurring, bizarre or incoherent responses or a combining of meaningless or unrelated words known as word salad.
The different type of Of psychotic disorders. Which of these are really worrisome and which ones are not
- Schizophrenia- A chronic mental illness with a patient does not return to his Premorbid Level of functioning. Patient will suffer from deliberating distortions of speech and thought, bizarre delusions, Hallucinations, social withdrawal
WORRISOME
- Paranoia- A Highly exaggerated or unwanted mistrust or suspicious of others. Hey paranoid patient has persecutory delusion Or an intense belief that one is being plotted against, harmed, spied on, or followed. Use caution when assessing and managing paranoid patients As they can exhibit aggressive behavior.
- Psychosis is any mental state in which the patient is out of touch with reality. The patient is living in his own world and often mistakes his reality for what is actually occurring. Psychosis can manifest through delusions, Hallucinations.
What medical conditions can mimic a psychiatric condition?
Low blood sugar, hypoxia, head trauma, drugs or alcohol, overdose
What are some of the features you look at when someone is going through a psychiatric issues
Unusual strength and endurance, tolerance of pain, agitation, hostility, bizarre behavior, unusual speech, hot and diaphoretic skin
The formula for a vehicle collision
The bodies mass and the bodies velocity.
Kinetic energy = mass x velocity2 / 2
The four phases of blast injuries
Primary phase- Due to the pressure wave of the blast.
Secondary phase- Due to flying debris is propelled by the force of the blast or blast wind. Most common are lacerations impaled object fractures and burns
Tertiary Phase- When the patient is thrown away from the blast.
Quaternary Phase- Injuries resulting from structural collapse and exposure to chemicals, toxins, bacteria, radiation.
The best information you want to know when someone gets stabbed.
The length of the object use in the stabbing provides valuable clues.
When are airbags most effective and when are they not effective?
Airbags are most effective when they are used with seatbelts. An airbag when used without lap and shoulder restraints can cause injury. He can deploy near the head neck or chest.
Contusion
Bruise, Injury to the tissue and blood vessels contained within the dermis. This type of injury causes localized swelling and pain at the injury site
Hematoma
Similar to a contusion, except it usually Involves damage to a larger blood vessel and the larger amount of tissue. It is Characterized by large lump with bluish discoloration cause by blood collecting under the skin.
Abrasion
It is caused by scraping, rubbing, for shearing away of the epidermis Which is the most layer of the skin.
Where are Occlusive dressings used?
Occlusive dressings creates an airtight seal for open abdominal, chest, and large neck injuries.
What are the three layers of skin from outer to inner?
The epidermidis, the dermis, and the sub q.
What is Evisceration? How do you deal with it?
It means abdominal organs protrude Through a wound. Do not touch the abdominal organs or try to replace the exposed organs. You need to cover the exposed organs using a sterile dressing.
Priority when dealing with a puncture patient?
The entry wound can appear small and cause little bleeding however such injuries can be deep and damaging and cost severe internal bleeding. The overall severity of the injury depends on the location, the size of the penetrating object, the depth of the penetration, and the force involved. He can be difficult to determine the extent of an injury based on the external wound. This is why you need to expose the patient and carefully inspect all areas of the body so that potentially life threatening injuries are not missed.
Why do you need to be careful with an abrasion?
Bleeding might not be significant or a serious life threat however contamination, infection and the potential of underlying injuries can be significant.
How do you handle an amputation?
- Remove any gross Contamination by flushing the part with sterile water.
- Wrap the part in a dry sterile gauze dressing
- Wrap or bag the amputated part in plastic
- Keep the amputated part cool.
What is an avulsion?
It is a loose flapper skin and underline soft tissue that has been torn loose or pulled completely off.
What is the rule of nines?
Adult = 9 each upper extremity and head/neck; 18 each lower extremity and front chest and back
Child = 9 each upper extremity; 18 head and chest/back; 14 each lower extremity
The number one priority when dealing with an electrical burn
The clothing can ignite resulting in flame burn so you need to remove it
What are the three types of burns (depth)
Superficial or first-degree burns. Sometimes there is swelling and skin appears pink to red and dry.
Partial thickness burns or second degree burns. Skin is red and weeping and there is a small leak in capillary beds. In deep partial thickness burns skin is wet and waxy dry.
Full thickness burns or third-degree burns involves all the layers of the skin. The tough and literally dead soft tissue formed in the full thickness burn is called eschar. Most full thickness burns are not painful because nerve endings have been destroyed.
