You have been called to an assisted living facility for a 43-year-old male patient who has a history of anxiety and schizophrenia and who, according to staff, is more confused today. The staff also states that the patient has refused to take his medications for the past three days. Your assessment reveals him to have no primary assessment life threats, but his speech is slurred and he does not make sense when he talks. As you review the paperwork provided to you by staff, you note that the patient has a history of thyroid problems, diabetes, and hypertension. His pulse is 124 beats/min, respirations 16 breaths/min, and blood pressure 154/70 mmHg. At this point, which action is most important?

Emergency medical services (EMS) providers should follow these steps for pre-hospital treatment of psychiatric disorders: Stabilize the crisis, Avoid coercion, Treat in the least restrictive setting, Form a therapeutic alliance, and Formulate an appropriate disposition and aftercare plan.  Here are some de-escalation techniques for psychiatric emergencies: Maintain a calm, reassuring, and compassionate tone of voice Ask the person's name and use the name they give you Do not touch the patient unless required and permission is given Physically lower yourself to eye level with the... Show more

Emergency medical services (EMS) providers should follow these steps for pre-hospital treatment of psychiatric disorders: Stabilize the crisis, Avoid coercion, Treat in the least restrictive setting, Form a therapeutic alliance, and Formulate an appropriate disposition and aftercare plan. 

Here are some de-escalation techniques for psychiatric emergencies:
Maintain a calm, reassuring, and compassionate tone of voice
Ask the person's name and use the name they give you
Do not touch the patient unless required and permission is given
Physically lower yourself to eye level with the patient
Slow down
Acknowledge hallucinations, but don't dismiss them: 
For example, "I understand that you see bugs. I do not see them. That sounds scary. We care about you and I would like to try to help you with that" 

Behavioral health emergencies are a priority for EMS professionals. 
These emergencies can take many forms, including:
Mental health crises, such as those related to bipolar disorder, schizophrenia, or PTSD
Intoxication due to alcohol, drugs, or both
Neurodegenerative disorders, such as Alzheimer's disease or dementia
Patients or bystanders who present a danger to themselves or others 

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