Special Populations & Operations · Chapter 33 Not started

Behavioral Emergencies and Crisis Response

De-escalation, suicide risk, and staying safe while caring for patients in psychological crisis.

Key points

Rule out medical causes first: hypoglycemia, hypoxia, head injury, hypothermia, and intoxication all masquerade as 'behavioral' problems.
De-escalation basics: calm tone, space, one person talking, listen more than you speak, no arguing with distorted beliefs, no cornering — keep your exit clear.
Take every statement about self-harm seriously; asking directly about suicide does not plant the idea — it opens the door to help.
Never leave a patient at risk of self-harm alone; involve law enforcement and follow protocol for protective custody where applicable.
Restraint is a last resort, done per protocol with law enforcement, never face-down, with continuous monitoring of breathing.
Critical incident stress affects rescuers too — debriefs and peer support after bad calls are part of the job, not a weakness.

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