RISK MANAGEMENT: DE-ESCALATION/ESCALATION ACTING OUT

AT EVERY PHASE: #1 = Empathic Listening (MOST IMPORTANT TOOL) Offer re-assurance/reality orientation Assist with recalling/identifying crisis prevention tools/activities Assist with use of tools/activities Add helpful strategies to the patients plan

CRISIS PHASE

BEHAVIORAL CUES

INTERVENTION SUGGESTIONS

ACTING OUT Crisis intervention Supportive/FIRM containment Assist with non-violent physical interventions (if needed) Own room? Quiet room? FIGHT OR FLIGHT MODE: extreme behaviors Code ORANGE Specialized Treatment Plan 5 minute checks??

Physical Cues:
Intense staring Absent eye blink Flushed Vitals Shaking Chest pain Nausea Headache Posturing Angry Hostile Irrational Scared/paranoia Panic

Physical Emotions Actions

Emotional Cues:

Actions:
Yelling/Screaming Hitting/Pushing/Shoving Pinching/Grabbing Throwing things Throw self on floor Self-harm Harm others Attempting to elope

Code ORANGE Remove audience Direct to own room or quiet room o Time out in room Concrete/clear instruction Reality orientation & reassurance o Explain situation & consequences Decrease environmental stimulation Offer PRNs Give space Restraint: Chemical or Physical? 5 minute checks?? Self-soothing techniques (if safe) o Weighted blanket? o Deep breathing? o Aromatherapy?

EXAMPLE: Problem identified: Anxiety Calm

______________________________________________ 0 1 2 3 4 5 6 7 8 9 10

Crisis

Calm/relaxed pre-anxiety anxious/frustrated defensive Feel good Body feels tense Muscle aches Headache Peaceful Pre-occupied Ruminating thoughts Angry thoughts

Outbursts Yell or cry

------------------ Increased loss of self-control

Champagne, 2006