Medical problems not to miss that might appear to be a mental health/psych/behavioural issue

[BEorP]

For full disclosure, I will preface this by mentioning that I am working on a lecture for paramedic students about this so this discussion is likely to help with that. Still, I think that it is an interesting topic to have a discussion on.

My question is what underlying medical problems that might be interpreted as a mental health/psych/behavioural issue prehospitally should paramedics be sure not to miss. There are obviously many illnesses that could present this way, but I am wondering which you think prehospital providers should be able to identify specifically (rather than just recognising that the patient is sick based on their overall assessment and taking them to the hospital).

Hypoglycaemia is obviously the first one that comes to mind, but what else do you think should be high up on the list?

I appreciate any thoughts. I will share more of mine later, but I didn't want to risk stifling discussion by sharing my opinion too early.

[MariB]

Bladder infections in the elderly.

[Just Plain Ruff]

Strokes that manifest with violent behaviour. Had a stroke patient who was very violent yet mostly lucid. Patient ended up with repair of the bleed and went on to live a productive life so far.

HOw but brain tumors that make patients do irrational things.

Dystonic reaction could be interpreted to be a mental health issue.

And many people (providers as well) just assume that all homeless people have a mental issue and thus treat them as such.

[paramedicmike]

Steroid induced psychosis.

[scubanurse]

Hepatic encephalopathy can cause a lot of behavioral changes

[paramedicmike]

Steroid induced psychosis.

By which I mean prescriptions steroids like prednisone as opposed to illegal performance enhancing steroids. Although, it is a possibility with both.

[scubanurse]

/> By which I mean prescriptions steroids like prednisone as opposed to illegal performance enhancing steroids. Although, it is a possibility with both.

I was always told to let patients know prescription steroids are like being on the worst PMS mood swings possible.

[AnthonyM83]

Various chemical imbalances.... ammonia, potassium, sodium, glucose, metabolic, etc.

Drug poisoning / overdose.

Hypoxia.

[ERDoc]

Crap, Mike beat me to the steroid psychosis. How about temporal lobe seizures.

[paramedicmike]

I was always told to let patients know prescription steroids are like being on the worst PMS mood swings possible.

Steroid induced psychosis puts steroid induced mood swings to shame.