lesson 21 behavioral emergencies - websites.rcc.edu
TRANSCRIPT
© 2011 National Safety Council
BEHAVIORAL EMERGENCIES
LESSON 21
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Behavioral Emergencies
• Process of giving first aid may be complicated by
victim’s behavior
• Many injuries or illnesses can cause altered mental
status or emotional responses
• Victims may have emotional problems
• Abuse and rape are behavioral situations
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Emotional and Behavioral Responses
to Injury and Illness
• Normal reactions include fear, anxiety and apprehensiveness
• Normal reactions may cause trembling, shakiness, nausea, fast heartbeat and breathing, perspiration
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• Do not judge victim’s behavior too quickly – assess
the situation
• If it is unsafe, call 9-1-1 and stay at a safe distance
until help arrives
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Emotional and Behavioral Responses
to Injury and Illness continued
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Altered Mental Status
• Results from many different injuries and illnesses
- Lowered levels of responsiveness may result from low
oxygen levels
• Victim may feel dizzy, drowsy, disoriented or
confused
• First aid is often treating underlying cause
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Causes of Altered Mental Status
• Respiratory
emergencies
• Cardiac emergencies
• Poisoning
• Head injuries
• Seizures
• Diabetic emergencies
• Stroke
• High fever
• Substance abuse
• Drug overdose
• Heat or cold
emergencies
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Reassuring and Calming Victims
• Tell victim who you are
• Say you are there to help
• Avoid seeming judgmental
• Do not assume victim is intoxicated or on drugs
• Reassure victim that help is on the way
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• Speak in a caring, reassuring voice
• Do not give false reassurances or lie about victim’s
condition
• Do not argue
• Show you understand by repeating or rephrasing
what victim says
• Do not challenge irrational or delusional statements
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Reassuring and Calming Victims continued
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• Stay a safe distance until victim accepts your help
- Do not attempt to restrain or force care
- Withdraw if scene not safe
• Tell victim what you plan to do before doing it
• Move calmly and slowly
• Touch victim only as necessary
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Reassuring and Calming Victims continued
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Actions For Victim With Anxiety
• Remain calm and patient
• Follow guidelines for calming and reassuring victim
- Often panic will subside in few minutes
• Victim may need more time to calm down and may suddenly experience renewed anxiety
• Be empathetic and gentle
• Allow victims to talk about their feelings
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Common Signs and Symptoms of
Depression
Signs and symptoms:
• Frequent feelings of sadness
• Loss of energy
• Feelings of hopelessness or worthlessness
• Difficulty concentrating
• Difficulty making decisions
• Physical symptoms (abdominal pain, insomnia, appetite loss, recurrent headaches)
• Thoughts of death or suicide
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Actions for a Victim With Depression
• Encourage victim to talk
• Acknowledge that person seems sad and ask why
• Show victim you care
• Help make person comfortable
• Allow person to cry and work through emotion
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• Listen sympathetically to complaints but do not offer
false reassurances
• Talk about available resources
• Be alert to possibility of suicide
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Actions for a Victim With Depression continued
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Suicide
• Over 33,000 people commit suicide each year
• Third leading cause of death among those 15-24 years old
• 11th leading cause of death for persons ages 10 and older
• Drug overdose and firearms most common methods
• Most victims talk about committing suicide
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Suicide Warning Signs
• Talking about suicide
• Comments about hopelessness or worthlessness
• Taking risks that could cause death
• Loss of interest in past activities
• Suddenly and unexpectedly seeming calm or happy
after being sad
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Actions for Person Who May be
Suicidal
• Take person seriously
• Listen to what he or she is saying
• Ask what person is planning to do
• Talk calmly and be supportive
• Do not argue with person
• Tell person you understand and care
- Do not give false reassurances
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• Call 9-1-1 if appropriate
• Involve friends or family members
• Do not leave person alone (unless your own safety is
threatened)
• Remove any weapons, drugs or medications
• Don’t let person drive
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Actions for Person Who May be
Suicidal continued
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• If person has firearm or is threatening violence
- Call 9-1-1
- Do not try to restrain the person
- Withdraw if situation becomes violent
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Actions for Person Who May be
Suicidal continued
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Actions For Person Who May
Become Violent
• Do not enter unsafe scene
• Call 9-1-1
• Do not attempt to restrain person
• Monitor situation from safe distance and wait for help
to arrive
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Abuse
• Intentional inflicting of injury or pain on someone under abuser’s power
• Victims include children, spouses, elderly parents
• Be sensitive to victim’s emotional status
• Be aware of special issues to handle situation
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Signs of Physical Abuse: Child
• Unexplained scalding or burns, rope burns,
lacerations, bites, bruises, broken bones
• Fading bruises or marks after absence from school or
childcare
• Seems frightened of parents and scared to go home
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Signs of Physical Abuse: Child continued
• Shrinks at approach of adult
• Reports being injured by someone
• Appears withdrawn, depressed, cries often
• Aggressive, disruptive
• Seems tired
• Complains of frequent nightmares
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Sexual Abuse
• Includes fondling child’s genitals, penetration, incest,
rape, sodomy, indecent exposure or exploitation
through prostitution or pornography
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Signs of Sexual Abuse: Child
• Difficulty walking or sitting
• Suddenly refuses to change clothes
• Reports nightmares or bed-wetting
• Sudden change in appetite
• Bizarre, sophisticated or unusual sexual knowledge
or behavior
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Signs of Sexual Abuse: Caregiver
• Unduly protective of child
• Severely limits child’s contact with other children
• Secretive and isolated
• Jealous or controlling with family members
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Reporting Child Abuse
• If you suspect abuse or neglect, report it to authorities
- Police
- Child protective services
• Your report will help protect child and get help for family
• Your report is confidential and may be anonymous
• You may be legally required to report it
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Care For Apparently Abused Child
• Do not confront parents
• Do not ask direct questions about abuse
• Provide first aid as usual
• Follow guidelines for documentation
- If child tells you injury caused by caregiver or other adult,
include this in report
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Signs of Domestic Violence
• Victim unusually fearful
• Victim’s account of injury inconsistent or unlikely
• Victim uneasy in presence of partner
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Guidelines for Suspected Domestic
Violence Situations
• Provide first aid as usual
• Call 9-1-1 for significant injuries and report any
suspicions
• Ensure privacy when providing care
• Do not directly confront victim with suspicions
• Try to involve friend or family member
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Guidelines for Suspected Domestic
Violence Situations continued
• You may be required to report suspected abuse
• If victim communicates abuse to you, you can tell
victim domestic violence is against the law and help is
available
• If you see physical abuse occurring or the threat of
violence, call 9-1-1 and stay away
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Elder Abuse
• Physical, emotional or financial abuse or neglect
inflicted on someone over age 60
- Affects more than 500,000 in United States each year
- 90% of cases, abuser is family member
- The older the person, the greater the risk
- The more person needs help with daily activities, the greater
the risk
- Abuse more likely to result in injury
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Signs and Symptoms of
Elder Emotional/Psychological Abuse
• Emotional upset or agitation
• Extreme withdrawal, lack of communication and
responsiveness
• Report of verbal or emotional abuse
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Signs and Symptoms of
Elder Neglect
• Dehydration, malnutrition, untreated bedsores, poor
personal hygiene
• Untreated health problems
• Unsafe living conditions
• Unsanitary living conditions
• Report of neglect
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Care For Victim of Elder Abuse
• All states have specific elder abuse laws
• Report suspected abuse to adult protective service agency
- Information is confidential
- State agency will investigate and provide services
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Sexual Assault and Rape
• Rape = forced sexual intercourse (both psychological
coercion and physical force)
• Sexual assault = completed or attempted attacks of
unwanted sexual contact (may or may not involve
force)
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Sexual Assault and Rape Statistics
• 1 of every 6 women is victim of attempted or completed rape in her lifetime.
• 17.7 million American women have been victims of attempted or completed rape.
• 2.78 million American men have been victims of sexual assault or rape.
• 9 of every 10 rape victims are female.
• 15% of sexual assault and rape victims are under age 12. 80% are under age 30.
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Care For Victim of Rape or Sexual
Assault
• Be sensitive to psychological trauma
• Call 9-1-1
• Ensure privacy for victim
• Try to involve friend or family member
• First aider of same sex may be better
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• Provide first aid as needed, stay with victim till help
arrives
• Preserve evidence
- Ask victim not to urinate, bathe or wash any area
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Care For Victim of Rape or Sexual
Assault continued
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Follow-Up Care
• Rape victims usually have full physical examination
• Possible later testing for STDs and pregnancy
• Counseling by rape crisis centers or support groups
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