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- When a patient presents with acute emotional distress:
- Take the necessary time to assist the patient, even if they present unexpectedly
- Acknowledge their feelings and help them de-escalate
- Employ the therapeutic effect of conversation
- As part of your management of a patient facing a crisis:
- Identify your patient’s personal resources for support (e.g., family, internal strength, friends) as part of your management of a patient facing a crisis.
- Offer appropriate community resources (e.g., counsellor) as part of your ongoing management of a patient with a crisis
- Negotiate a follow-up plan with the patient
- Be careful not to cross boundaries when treating a patient in crisis (e.g., lending money, providing appointments outside regular hours)
- When a patient presents with emotional distress or declares themselves in crisis:
- Carefully assess the risk of harm to themselves or others
- Ask your patient if there are others needing help associated with the crisis
- Act accordingly
- Use psychoactive medication rationally to assist patients in crisis.
- Inquire about unhealthy coping methods (e.g., drugs, alcohol, eating, gambling, violence, sloth, promiscuity) in your patients facing crisis.
- Prepare your practice environment for possible crises or disasters and include colleagues and staff in the planning for both medical and non-medical crises.
- When dealing with an unanticipated medical crisis (e.g., seizure, shoulder dystocia):
- Be calm and methodical
- Assess the environment for needed and available resources (people, material)
- Ask for the help you need
- Take timely action as appropriate in the context of the situation (e.g., resuscitation in the waiting room of the clinic versus in the emergency department)
- In all patients, to identify possible previous crises and avoid retraumatization during medical encounters:
- Be attentive to triggers for re-traumatization
- Recognize different manifestations of emotional distress
- Address as appropriate