Acute behavioural disturbance and positional/ restraint asphyxia

  1. Acute behavioural disturbance can occur in the context of?
    • psychiatric illness- typically psychosis 
    • physical illness- typically in confusion/ delirium 
    • substance misuse- typically alcohol withdrawal
  2. what is the definition of acute behavioural disturbance?
    • rare form of severe mania
    • sometimes considered part of the spectrum of manic depressive psychosis and chronic schizophernia
  3. what are the causes of acute behavioural disturbance?
    • psychiatric illness 
    • drugs (particularly cocaine) 
    • alcohol 
    • combination of these
  4. what are the risk of acute behavioural disturbance?
    • 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- following a struggle
  5. what conditions has acute behavioural disturbance been linked with?
    • head injury 
    • brain tumours 
    • delirium/ high temperatures 
    • epileptic post ictal states 
    • heat exhaustion 
    • hypo/ hyperglycaemia 
    • thyroid disease 
    • drugs... anti psychotic/ cocaine
  6. what are the S and S of Acute behavioural  disturbance?
    • bizarre and/ or aggressive behaviour 
    • impaired thinking 
    • disorientation 
    • hallucinations 
    • onset of paranoia
    • agitation 
    • excitability 
    • paranoia 
    • aggression 
    • non pain compliant 
    • great strength 
    • sudden collapse 
    • may ultimately result in death
    • removal of clothing
  7. how do you manage someone with acute behavioural disturbance?
    • police required 
    • do not put yourself at risk 
    • monitor patient for deterioration 
    • consider position of patient when restrained
  8. what position should someone be in when they are restrained?
    • sitting or kneeling 
    • lying on side 
  9. acute behavioural disturbance is linked to positional asphyxia. true or false
  10. what is acute behavioural disturbance often referred as?
    excited delirium
  11. what behaviour does a patient with acute behavioural disturbance exhibit?
    bizarre and manic behaviour
  12. when does positional/ restraint asphyxia occurs?
    when the position of the body interferes with respiration, resulting in asphyxia
  13. what may the pt not be able to do?
    alter their position due to restraint
  14. what are the risk factors for positional/ restraint asphyxia?
    • pt position resulting in partial or complete airway obstruction
    • patient left face down, prone, position 
    • pressure applied restricting the shoulder girdle or accessory muscles whilst laid down
  15. what are the factors that increase the risk of positional/ restraint asphyxia?
    • drugs/ alcohol intoxication 
    • physical exhaustion 
    • mental illness 
    • obesity
Card Set
Acute behavioural disturbance and positional/ restraint asphyxia
Acute behavioural disturbance and positional/ restraint asphyxia