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Discussion

what to do for pt in crisis

I have a question about the course of action to be taking when a pateint is in crisis.

#1 If a patient is in a medical offce with a young child and tells the provider and support staff that she is having a breakdown, feels out of control, is hallucinating (seeing double when driving) what can the staff do? Patient states that she feels like she needs emergency help but refuses ambulance. (hx of suicide attempts however no current mention of suicide)

#2 if above patient does drive home and later talks with support staff on phone and says that she is worse, hopelessnes, blacking out, throbbing head can staff call ambulance for patient? Is it right to make patient call even if they ask you to?

I am a nursing student, MA and EMT and was wondering what you think is the proper way to handle the situation.

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This is tricky and just a guess. First of all, if the woman refuses treatment, the very first thing I would do is ask, "Is there someone else who can take care of/drive (child's name) home? Is there anyone I can call who can help you?"

If you truly believe the child is in danger, I believe you have an obligation to call child/family services or the police.

If she is in a medical office, her doctor can contact someone who might be able to 'pink-slip' her for an involuntary admission to the psych unit for 72 hrs for some observation and treatment. Also, any time there might be a likely chance that a child could be harmed by a parent's errant behavior or negligence b/c the parent is not in control of even theirself, it is a duty of a healthcare professional to get involved. The police could be called and RESCUE could be brought in to pink-slip someone, or child-services could get involved for just the child's safety.

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