Ch 18 - Crisis Intervention

you may need to refer a pt/athlete to

emergency or nonemergency psychological services & hotlines

crisis intervention facts (2)

• everyone involved in a serious injury, sudden illness or death or death will face an emotional crisis

• normal natural rxn

suicide facts (3)

• leading cause of death 15-19 yo also common among adults of all ages

• do not place urself in fanger

• alert 911

physical assault (4)

• emergency scene not always safe (attacker still present or nearby)

• first concern is ur own safety

• if unsafe wait until law enforcement offficer is present

• do not handle items unrelated to pt care

sexual assault

occurs when someone is forced into any form of sexual activity without their consent

sexual assault (3)

• pt often feel degraded, frightened

• require sig emotional support

• try and control ur own rxn and focus on state and needs of pt

sexual assault care for (7)

• cover pt and protect

• have pt interact w responder of same gender if possible

• clear the areas of bystanders (except family and friends providing support)

• remove articles of clothing if absolutely necessary

• discourage pt from bathing/showering/cleaning until medical exam

• treat area as a crime scene

• do not question the pt about specifics of assault beyond absolutely necessary for providing care

death & dying

be cautious about what u saw in situations in which the death of a pt seems probably; “we are doing everything we can”

guidelines for responding (4)

• involves emotional support & caring for injuries

• verbal & nonverbal communication

• speak in a calm & reassuring manner

• avoid threatening body language

mental health crises def (C/C)

some disorder of mood, thought, or behaviour that is dangerous or disturbing to the pt or those nearby

mental health crises (4)

• most imp responsibility is to ID and care for injuries, NOT diagnose

• ensure safety of responders and scene 1st

• active listening w/o passing judgement

• provide support & refer

nonverbal communication

• get at eye level

• look at person when u talk

DO NOT

• make physical contact

• place arms across chest

• place hands on hips

• point @ casualty

active listening

make effort to understand pt → repeat back in ur own words → avoid criticism/anger/rejection → use open ended questions

psychosis

serious medical condition reflecting a disturbance in brain function

• loss of contact w reality, changes in thinking, beliefs, perception etc

• a person can’t tell the difference b/w what is reality and not

example of chronic psychosis

schizophrenia

psychosis S/Sx (6)

• loss of touch w reality

• false beliefs

• mania

• hallucinations

• confusion or disconnected thoughts

• suicidal ideation 

psychosis care for

• assess for potential violence

• responses may reveal bizaree or disorganized thought processes

• reasoning likely ineffective since pt have their own logic

• request law enforcement if necessary, assess for potential violence

anxiety

mental disorders in which the dominant mood is fear and apprehension

• may experience persistent, incapacitating anxiety in absence of external cause

anxiety S/Sx (9)

• hyperventilation

• feelings of weakness/faintness

• chest discomfort

• dizziness

• rapid HR

• sweating

• nausea

• smothering sensations

• fear of losing control

depression

clinical depression is a mood disorder

pt may express feelings of worthlessness hopelessness, guilt and or pessimism

depression imp facts (2)

• can be response to a stressful event

• any statements about suicide attempts of suicidal ideation should be taken seriously and documented

caring for depression pt

• calmly talking to pt

• direct pt thoughts away from topics of distress