Adult General Section Protocols Procedure if indicated IV Procedure overdose Cardiac Monitor Diabetic Protocol Monitorand Reassess Preferably 2 large bore ExternalCooling Measures YES Consider RestraintPhysical rders al syndromes I P manic-depressive ) hrenia Mental Status differentialMental Status l Intoxication Substance abuse/ Substance ar ( cation effect / ression NO Altered Alcoho Toxin Medi Withdraw Dep Bipol Schizop Anxiety diso · Differential · · · · · · · · hyper- , homicidal Violent, / NO increased strength, if indicated Agitation , disorientation hallucinations If indicated hyperthermia , , Protocol 6 behavioral change Aggressive, Setting of Psychosis Threat to Self or others Head Trauma Protocol agitation, confusion on of suicidal Notify Destination or aggression, hallucination, , change Contact Medical Control Excited Delirium Syndrome ative violent Exit to Appropriate Protocol Exit to Blood Glucose Analysis Procedure Paranoia tachycardia Altered Mental Status Protocol Altered Mental Status Behavioral , bizarreusional, thoughts Toxic Ingestion Protocol Protocol Overdose/Toxic Ingestion Assume of has Medical cause patient Affect Anxiety Del Comb Expressi thoughts behavior · Signs and Symptoms Signs · · · · YES YES if indicated IV Procedure Any local EMS System changes to this document must follow the NC OEMS Protocol Change Policy and be approved by OEMS Monitor and Reassess / overdose ce abuse / tric illness/medicationstric nal crisis Safe Scene c alert tag Monitorper restraint procedure betes resources Consider RestraintPhysical Procedure Injury to self or threats to others Injury to self Medi Substan Dia Situatio Psychia Revised 8/13/2012 NO Stage until scene safe I · · · History · · · Callhelp for / additional P Adult General Section Protocols in , head tatus. PO , -threatening IM / May present / . IO / Most commonly seen in male . speech disturbances , substance abuse, hypoxia , particularly stimulantdrugs as such neck and upper extremities , overdose , . anxiety, hallucinations , hypoglycemia ( hyperthermia and increasedstrength. Potentially life consider a fluid bolus and sodium bicarbonate early , Neuro includingphysical restraints and Tasers mg IV When recognizedgive 50 mg IV Diphenhydramine . Protocol 6 , , Lungs psychomotor agitation , amphetamines or similar Alcohol agents. withdrawal or head trauma may also . , Heart, insensitivity to pain Behavioral , in pediatrics. PO / IM / : methamphetamine bizarre behavior , : IO / / Combinationdelirium of Mental Status, Skin, : . er all possible medical/trauma causesfor behavior or Ziprasidone for patients with history of psychosis or a benzodiazepine for patients with presumed for patients psychosis or a benzodiazepine history of for patients with or Ziprasidone kg IV mg/kg IV ho is handcuffed or restrained by Law Enforcement and transported by EMS must be accompanied by law by EMS must be accompanied by Enforcement transported and or restrained by Law ho is handcuffed 1 crack cocaine Any local EMS System changes to this document must follow the NC OEMS Protocol Change Policy and be approved by OEMS ramidal reactions t irritate the patientt with a prolonged exam. overlookt the possibility of associated domestic violence or child abuse positiont or transport any restrainedcould patientis suchaway impact that the patients respiratory or circulatory s atients who receive either physical or chemical restraint must be continuously observed by ALS personnel on by ALS personnel observed atientswho receive either physical or chemical restraintmustbe continuously adultsor Condition causing involuntary muscle movements or spasms typically the face of Medical emergency with contorted neck and trunk with difficultmotormovements . Typically an adverse reactionantipsychoticdrugslike to Haloperidol and may occur withyour administration disorientation, violent andassociated withuse physical of control measures, subjectswithserious a history of mentalillness and /or acute or chronic drug abuse, cocaine, contribute the condition to . : ommended Exam: w / responders safetyis the main priority w patient is suspected of agitated delirium cardiac suffers arrest, ed injury.) , etc substance abuse their arrivalsceneor immediatelyupon . Be sure to consid Consider Haldol All p Rec Cre Any patient w enforcementthe ambulance. in Excited Delirium Syndrome Do no If Do no Do no Extrapy Revis 8/13/2012 · · · Pearls · · · · · · · · ·