· Medications · Delusional thoughts, bizarre behavior · Medication effect / overdose · Injury to self or threats to others Combative violent · Withdrawal symptoms ∙ · Medic Alert tag Expression of suicidal / homicidal thoughts · Depression ∙ ∙ Substance abuse / overdose · Bi-polar (manic-depressive) ∙ Diabetes · Schizophrenia ∙ · Anxiety · See Altered Mental Status differential Universal Patient Care Protocol Legend EMT Evidence of immediate danger scene immediately A EMT-A A Yes to crew? P EMT-P P M MC Order M Call for police assistance Attempt verbal control Yes No Successful No Restraint Procedure prn Or monitor situation and Police Obtain IV Access prn A A ECG/ 12 Lead prn P P Lorazepam P or prn P Midazolam Seizure M Contact Medical Control M History: Differential: Signs / Symptoms: · Prior History of seizures · Fever ·Observed Seizure activity · Seizure Medications · Infection · Reported Head ∙ Pearls: Meds: seizure Lorazepam 0.5-2 mg IV/IM Your Safety first! activity Midazolam 2.5-5 mg IV/IM Be sure to consider all possible medical/trauma causes for · History of behavior (hypoglycemia, overdose, substance hypoxia, recent head injury, etc) Head Do not irritate the patient with a prolonged exam. Trauma Do not overlook the possibility of associated domestic violence · Congenital or child abuse abnormality Trauma · Altered Mental Status ∙ · Medication or Toxin Pregnancy (see Eclampsia) · Tonic / Clonic Activity Medical Alert Tag Incontinence · Hypoxia or Respiratory failure ∙ ∙ · Hypoglycemia Mouth Trauma ∙ · Metabolic abnormality / acidosis · Tumor Universal Patient Care Protocol Legend EMT A EMT-A A
· Medications · Injury to self or threats to others · Medic Alert tag ∙ ∙ Substance abuse / overdose ∙ Diabetes · Delusional thoughts, bizarre behavior ∙ Combative violent ∙ Expression of suicidal / homicidal thoughts · Medication effect / overdose · Withdrawal symptoms · Depression · Bi-polar (manic-depressive) · Schizophrenia · Anxiety · See Altered Mental Status differential Universal Patient Care Protocol Legend EMT A EMT-A A P EMT-P P M MC Order M Evidence of immediate danger to crew? scene immediately Yes Call for police assistance Attempt verbal control Successful Yes No No Restraint Procedure prn Or monitor situation and Police A Obtain IV Access prn A P ECG/ 12 Lead prn P P Lorazepam or prn Midazolam P Pearls: Your Safety first! Be sure to consider all possible medical/trauma causes for behavior (hypoglycemia, overdose, substance hypoxia, head injury, etc) Do not irritate the patient with a prolonged exam. Do not overlook the possibility of associated domestic violence or child abuse Meds: Lorazepam 0.5-2 mg IV/IM Midazolam 2.5-5 mg IV/IM M Contact Medical Control M Seizure History: · Prior History of seizures · Seizure Medications · Reported seizure activity · History of recent Head Trauma · Congenital abnormality ∙ Pregnancy (see Eclampsia) ∙ Medical Alert Tag Signs / Symptoms: ·Observed Seizure activity · Altered Mental Status · Tonic / Clonic Activity ∙ Incontinence ∙ Mouth Trauma Differential: · Fever · Infection ∙ Head Trauma · Medication or Toxin · Hypoxia or Respiratory failure · Hypoglycemia · Metabolic abnormality / acidosis · Tumor Universal Patient Care Protocol Legend EMT A EMT-A A