PARA225 Week 10 Mental Health Summary

What is the first priority at an ABD scene?

Scene safety: identify hazards, weapons, exits and risks to others.

What does ABD stand for?

Acute behavioural disturbance.

What are the three QAS emergency sedation criteria?

SAT ≥ +2, imminent serious harm risk, and unsuccessful verbal de-escalation.

What does SAT assess?

The patient's level of agitation, behaviour and responsiveness.

What does SAT +3 indicate?

Combative, violent or out of control behaviour.

What does SAT 0 indicate?

Awake, calm and cooperative.

What is the minimum QAS sedation team?

Two clinicians: Sedation Supervisor and Sedation Assistant.

Which clinicians may administer droperidol for ABD?

Authorised ACP2 and CCP clinicians, subject to the DTP.

Who may administer midazolam for ABD?

Authorised ACP2 and CCP clinicians, subject to the DTP.

Who may administer ketamine for ABD?

CCP clinicians only, subject to the DTP.

Name key contraindications to emergency sedation.

Haemodynamic instability and a compromised or difficult airway.

How often are SAT and vital signs recorded after sedation?

Every 5 minutes.

What airway equipment must be immediately available for sedation?

Bag-valve-mask, suction and airway equipment.

What is the priority in suspected opioid toxicity?

Support airway and ventilation; treat respiratory depression.

What is naloxone used for?

Reverses opioid effects, particularly opioid-induced respiratory depression.

Why must patients be monitored after naloxone?

Opioid toxicity may recur when naloxone wears off.

What are key signs of stimulant toxicity?

Agitation, paranoia, tachycardia, hypertension, sweating and possible hyperthermia.

What are serious complications of stimulant toxicity?

Seizures, hyperthermia, MI, stroke, dysrhythmias and rhabdomyolysis.

What are key signs of serotonin toxicity?

Agitation, fever, sweating, tremor, hyperreflexia and clonus.

What ECG concern is associated with TCA overdose?

QRS widening and potentially life-threatening dysrhythmias.

What are common features of lithium toxicity?

GI upset, tremor, ataxia, confusion and potentially seizures.

What are three types of extrapyramidal symptoms?

Acute dystonia, akathisia and drug-induced parkinsonism.

What is the difference between mood and affect?

Mood is patient-reported emotion; affect is observed emotional expression.

What should you assess when a patient expresses suicidal thoughts?

Intent, plan, access to means, timing, previous attempts and protective supports.

Why should agitation not automatically be labelled psychiatric?

Medical, neurological, traumatic and toxicological causes must be considered.

What does IMIST-AMBO structure?

Patient identification, complaint/mechanism, injuries, signs, treatment, allergies, medications, background and other information.

What should guide exact medication doses and repeat intervals?

The current QAS Drug Therapy Protocol (DTP) and clinician authorisation.

What is the exam structure for PARA225 Week 10?

120 minutes, 50 multiple-choice questions + 2 case studies, 100 marks total (worth 40% of unit).

What is the primary rule before assuming a psychiatric cause in a patient?

Do not assume a psychiatric cause until medical causes have been considered.

What does MSE stand for and what is it?

Mental Status Examination: a systematic snapshot of current emotional and cognitive functioning.

What is anosognosia?

A lack of awareness of one's illness.

What are positive symptoms of psychosis?

Additions to normal functioning, such as hallucinations, delusions, and abnormal behaviour.

What are negative symptoms of psychosis?

Reductions in normal functioning, such as less speech, emotional expression, and social drive.

What criteria define Major Depressive Disorder (MDD)?

5 or more symptoms over a 2-week period representing a change from baseline, including depressed mood or anhedonia.

What distinguishes mania from hypomania?

Mania causes marked impairment, hospitalisation, or psychosis and lasts at least 1 week; hypomania lasts at least 4 days without severe impairment.

What is the physiological effect of hyperventilation?

It lowers CO2 (hypocapnia), causing respiratory alkalosis.

What does the acronym MORE PIES stand for in de-escalation?

Minimal encouragers, open questions, reflecting/mirroring, emotional labelling, paraphrasing, 'I' messages, effective pauses, summaries.

What is diagnostic overshadowing?

Incorrectly attributing physical symptoms to mental illness and missing another cause.

What key statistic was cited regarding healthcare stigma from the National Stigma Report Card?

87.2% reported unfair treatment by healthcare professionals and 77.8% stopped themselves seeking help.

What are the 7 steps of the case-study answer structure?

1. Immediate threats/safety, 2. Relevant findings/MSE, 3. Differential list, 4. Targeted assessment/history, 5. Prioritise treatment, 6. Reassess/document, 7. IMIST-AMBO handover.