Positional/Restraint asphyxia and Acute Behavioral Disturbance Flashcards Preview

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Flashcards in Positional/Restraint asphyxia and Acute Behavioral Disturbance Deck (13)
1

Positional/Restraint Asphyxia - definition

Occurs when the position of the body interferes with respiration, resulting in asphyxia.

Patient not able to alter their position due to restraint.

2

Positional/Restraint Asphyxia - Risk factors include

Patients position resulting in partial or complete airway obstruction.

Patient left face down/prone.

Pressure applied restricting the shoulder girdle or accessory muscles whilst laid down.

3

Positional/Restraint Asphyxia - Factors increasing risk

Drug/alcohol intoxication.
Physical exhaustion
Mental illness
Obesity

4

Acute Behavioural Disturbance - information

A syndrome in which the patient exhibits bizarre and manic behaviour.
Can prove rapidly fatal.
Linked to positional asphyxia
Often referred to as excited delirium
Considered a medical emergency

5

Acute Behavioural Disturbance - definition

A rare form of severe mania, sometimes considered part of the spectrum of manic depressive psychosis and chronic schizophrenia.

6

Acute Behavioural Disturbance - Causes

Psychiatric illness
Drugs (particularly cocaine)
Alcohol
Combination of these

7

Acute Behavioural Disturbance - Risks

Rapid deterioration and death due to cardiac arrest from drug-induced arrhythmias.

Greater risk of positional asphyxia, especially in obese patients.

May be exacerbated by exhaustion e.g. following struggle.

8

Acute Behavioural Disturbance - has been linked to

Head injury
Brain Tumours
Delirium/high temperature
Heat exhaustion
endocrine (hormone secretion system) disorders
Hypo/Hyperglycaemia
Thyroid disease
Drugs; anti-psychotic/cocaine.

9

Acute Behavioural Disturbance - signs and symptoms

Bizarre and/or aggressive behaviour
Impaired thinking
Disorientation
Hallucinations
Onset of paranoia

10

Acute Behavioural Disturbance - presenting features (things to look for)

Agitation
Excitability
Paranoia
Aggression
Non pain-compliant
Great strength
Sudden collapse
May ultimately result in death!

11

Acute Behavioural Disturbance - features

High level of physical strength
Sweating, fever, heat intolerance, hot to touch
Removal of clothing
Decreased/absent response to pain
Sudden tranquillity after frenzied activity which may mask level of consciousness

12

Acute Behavioural Disturbance - management stage 1

If police on scene, should already be trained in safe management.
Summon police assistance if not present.
Do not place self at risk.
Monitor patient for deterioration.
Consider position of patient when restrained - sitting or kneeling, lying on side. NOT FACE DOWN!

13

Acute Behavioural Disturbance - management stage 2

Personal safety is paramount.
Ideally the patient should be contained rather then restrained.
When safe, conduct primary survey.
Treat as required.
Document observations.
Secondary survey if possible/required.
Ideally transport in ambulance.
Transport to A&E.