5-5.
DISORIENTATION
a. Disorientation is a disturbed mental state characterized by confusion regarding
one's relationship to physical surroundings, time, or person. It may be a sign of
underlying illness, injury, or stressful situation--not separate disease state.
NOTE:
It is always important to consider the underlying contributing factors/cause of
the disoriented or confused behavior. Many similar conditions, illnesses, or
injuries may contribute to or cause manifestations of disorientation, disturbed
behavior, and/or violent behavior. It is essential, after reacting to the particular
situation presented, that each casualty or patient be carefully evaluated both
physically and mentally to determine the true physiological cause of any
behavioral emergency.
b. Management of a confused/disoriented patient.
(1)
Prevent the patient from harming himself and/or others.
(2)
Use the patient's name frequently.
(3)
Give frequent reassurance as to time, place, and situation.
(4)
Explain any procedures or actions simply, but in detail.
(5) Decrease sensory stimulation by providing simplified environment (a quiet
and well-lit room, and so forth).
(6) Evaluate the patient for the underlying illness or injury suspected to
precipitate the disorientation.
5-6.
VIOLENT BEHAVIOR
a. Violent behavior is behavior that is potentially hazardous to the patient and/or
others. It also is not peculiar to any one type of diagnosis; however, there are certain
conditions and situations that might indicate a potential for violence. Most of the factors
that might precipitate other disturbed behaviors are also known to occasionally precipitate
violence.
b. Potentially, violent episodes should be anticipated. Be aware that some (but
not all) patients in stressful situations may pass through the four stages of crisis
development. If you are able to recognize these stages, you may be able to intervene
early and appropriately.
(1)
Stages of crisis development.
(a)
Anxiety.
MD0549
5-5