learning Objectives - Explain different psychiatric emergencies and their management Demonstrate skills in crisis intervention
Hours - 5
Teaching and Learning Activities - Lecture cum discussion Videos Role plays Demonstration
Assessment Methods - Short answers Objective Type Essay type
Content of the chapter
a) Types of Psychiatric emergencies: Over
Active, under active patient, Violent
behaviour,
b) Suicide, adverse drug reactions, withdrawal
symptoms, Acute psychosis etc
c) Crisis and its intervention: AIDS,
Adolescent Crisis
Introduction
Psychiatric emergencies are acute disturbances of behavior, thought, or mood that pose an immediate risk to the patient or others and require prompt assessment and intervention. Crisis intervention aims to restore psychological balance and prevent further harm.
a) Types of Psychiatric Emergencies
1. Over-Active Patient
Characteristics:
- Hyperactivity
- Agitation
- Aggression
- Excessive talking
- Insomnia
Causes:
- Mania
- Acute psychosis
- Substance intoxication
Nursing Management:
- Maintain safety
- Calm environment
- Set clear limits
- Administer prescribed medications
- Continuous observation
2. Under-Active Patient
Characteristics:
- Withdrawal
- Psychomotor retardation
- Mutism
- Poor self-care
Causes:
- Severe depression
- Catatonia
- Schizophrenia
Nursing Management:
- Encourage communication
- Assist in self-care
- Monitor nutrition and hydration
- Suicide precautions
3. Violent Behaviour
Characteristics:
- Threatening gestures
- Physical aggression
- Property destruction
Causes:
- Psychosis
- Substance abuse
- Frustration and fear
Nursing Management:
- Ensure safety of patient and others
- Use de-escalation techniques
- Physical restraints only as last resort
- Documentation
b) Psychiatric Emergency Conditions
1. Suicide
Risk Factors:
- Depression
- Substance abuse
- Previous attempts
- Hopelessness
Warning Signs:
- Talking about death
- Giving away belongings
- Sudden mood changes
Nursing Interventions:
- Never leave patient alone
- Remove harmful objects
- Provide emotional support
- Refer for psychiatric evaluation
2. Adverse Drug Reactions
Examples:
- Extrapyramidal symptoms
- Neuroleptic malignant syndrome
- Serotonin syndrome
Nursing Management:
- Early identification
- Stop offending drug
- Emergency medical care
- Monitor vital signs
3. Withdrawal Symptoms
Seen in alcohol, opioids, sedatives.
Symptoms:
- Tremors
- Anxiety
- Seizures
- Delirium tremens
Nursing Care:
- Monitor withdrawal scales
- Administer detox medications
- Maintain hydration
- Prevent complications
4. Acute Psychosis
Symptoms:
- Hallucinations
- Delusions
- Disorganized behavior
Nursing Management:
- Reality orientation
- Calm reassurance
- Medication administration
- Safety monitoring
c) Crisis and Its Intervention
Crisis
A crisis is a sudden event that overwhelms an individual’s coping ability, leading to psychological imbalance.
Types of Crisis
1. AIDS-Related Crisis
- Fear of death
- Social stigma
- Depression and anxiety
Intervention:
- Emotional support
- Health education
- Counseling
- Referral to support groups
2. Adolescent Crisis
Causes:
- Identity issues
- Academic stress
- Substance abuse
- Relationship problems
Intervention:
- Active listening
- Counseling
- Family involvement
- Life-skills education
- Suicide prevention
Steps of Crisis Intervention
- Assessment of crisis
- Establish rapport
- Identify major problems
- Explore feelings
- Develop coping strategies
- Mobilize support systems
- Follow-up and evaluation
Conclusion
Psychiatric emergencies require rapid assessment, safety measures, and compassionate intervention. Nurses play a critical role in crisis management, suicide prevention, medication monitoring, and psychosocial support, helping individuals regain emotional stability and prevent long-term complications.