2015 Trumbull Memorial Hospital Demo

Agitation / Combativeness Agitation / Combativeness

Scene Safety Law Enforcement should always be requested

Clinical Considerations Agitation causes may include:  Excessive heat/cold  Hypoxia  Lack of blood flow to brain  Head injury or stroke  High or low BGL

Only restrain the patient if they are threatening the safety of themselves, the crew, or others. Do not attempt to subdue or restrain unless adequate personnel are present and law enforcement is on the scene. Evacuate if they are not.

Universal Patient Assessment

 Metabolic disorders  Neurologic disease

Remove patient from stressful environment

Keep in mind that many accidental needle sticks occur on medical personnel while dealing with violent or agitated patients.

Try to identify and treat the underlying cause of the agitation.

If there is no treatable cause and the patient remains a threat to themselves or others, the paramedic may choose to attempt medical sedation

History of Schizophrenia or Allergy to Ketamine

Yes

No

Haldol 5mg IM And / Or Versed 5mg IM Have suction, BVM, and

Ketamine 1mg/kg IM

Have suction, BVM, and intubation equipment ready, be prepared to protect the airway, consider extra resources. Monitor SpO2 and ETCO2.

intubation equipment ready, be prepared to protect the airway, consider extra resources. Monitor SpO2 and ETCO2.

May repeat Haldol 5mg IM in 10 minutes if patient is still combative and vital signs are adequate.

32

EMR

EMT

AEMT

Paramedic

Extended