Excited/Agitated Delirium

[FL_Medic]

Cardiac arrest dose is 1mEq/kg. I believe crush syndrome requires a similar dose. Just delivering 1 amp to any patient doesn't make much since, but as stated it is prophylactic anyhow. In conjunction with NS it would probably do the trick on most patients, but we are attempting to practice evidence-based medicine here.

Edited March 30, 2009 by FL_Medic

[crotchitymedic1986]

Your first policy should be to try not to have to restrain them at all. I always try talking to the patient first, and see if i can calm them down. Just because they are mad at to po-po doesnt necessarily mean that they can not be reasoned with. If that fails, then you should restrain them with soft or leather restraints as described in the article i linked:

Restrain both ankles to stretcher, use stretcher straps as usual, restrain the dominant arm above the patients head to the t-connect at the back of the stretcher, and the other arm to the stretcher beside their leg. You should immediately do a full assessment, and do repeat assessments often. Once the patient arrests, it is like a trauma arrest, only a fraction of one percent live to walk out of the hospital. The article suggests moving the chest stretche strap to a higher position (under the armpits), but most have gone to the racing harness, so that may not be necessary for you depending on the straps you have.

The key thing to know is that these patients will appear like hyperventilation patients, but they do not get better once they "pass out".

P.S. When this article was first published it was titled : "Positional Asphyxia; Death by EMS"

Edited March 30, 2009 by crotchitymedic1986

[FL_Medic]

Your first policy should be to try not to have to restrain them at all. I always try talking to the patient first, and see if i can calm them down. Just because they are mad at to po-po doesnt necessarily mean that they can not be reasoned with. If that fails, then you should restrain them with soft or leather restraints as described in the article i linked:

Restrain both ankles to stretcher, use stretcher straps as usual, restrain the dominant arm above the patients head to the t-connect at the back of the stretcher, and the other arm to the stretcher beside their leg. You should immediately do a full assessment, and do repeat assessments often. Once the patient arrests, it is like a trauma arrest, only a fraction of one percent live to walk out of the hospital. The article suggests moving the chest stretche strap to a higher position (under the armpits), but most have gone to the racing harness, so that may not be necessary for you depending on the straps you have.

The key thing to know is that these patients will appear like hyperventilation patients, but they do not get better once they "pass out".

P.S. When this article was first published it was titled : "Positional Asphyxia; Death by EMS"

Yea, a hyperventilation patient that hates everyone. I have had these patients present in different ways. In my experience the common factor is usually drugs or alcohol. I have had the patients seem to be euphorically happy and then like a switch, change to a LSD-like patient. In my experience, they also get worse the harder you or LE fight/struggle with them. Crotchity is right about attempting to talk them down, although you may not feel completely safe even if you do get them talked down. If you chose not to restrain them I would have LE close by. Frequently, I have noticed the alcohol abusers may befriend someone on scene, stating "I like you" or "I love this guy, the rest of you are assholes". It may be a good idea to have that person do the talking. Like I said, this is all just anecdotal from my experiences.

Edited March 30, 2009 by FL_Medic

[croaker260]

http://www.adaweb.net/LinkClick.aspx?filet...d&tabid=798