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MEDICAL - PSYCH NURSING DISCUSSION

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A MAGIC BULLET WILL BE NEEDED TO KILL THE 17TH AMENDMENT
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COMBAT LEADER'S HANDBOOK PART 1
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COMMITTEE OF SAFETY - COMMON LAW COURT
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FREEDOM FROM WAR BY PRESIDENT JOHN KENNEDY TO THE UNITED NATIONS - 1961
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MEDICAL - WINDCHILL CHART
MISSION PLANNING: Step 1 Strategic goals
MISSION PLANNING: Step 2 Missions and the SG's
MISSION PLANNING: Step 3 Tactical Planning an overview
MISSION PLANNING: Step 4 Warning Order Part 1
MISSION PLANNING: Step 5 SMEAC
MISSION PLANNING: Step 6 Mission Statement
MISSION PLANNING: Step 7
MISSION PLANNING: Step 8 Finalized Situation Report.
MISSION PLANNING: Step 9 The meat of the whole deal - EXECUTION
MISSION PLANNING: Step 9a The general make up of the team
MISSION PLANNING: Step 9b Planning for the HOME Team deployment
MISSION PLANNING: Step 9b (a) LR Execution
MISSION PLANNING: Step 9c Home Team Insertions
MOUNTED LAND NAVIGATION
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PATROLLING 101 - TIRE IRON STYLE
POISONOUS PLANTS
PROCEEDINGS OF COMMISSIONERS TO REMEDY DEFECTS OF THE FEDERAL GOVERNMENT : 1786
RECONNISSANCE PATROLS
ROBERT ROGER'S STANDING ORDERS
RON PAUL AND THE MILITIA
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THE ANTI-FEDERALIST PAPERS 1-17
THE ANTI-FEDERALIST PAPERS 18-34
THE ANTI-FEDERALIST PAPERS 35-51
THE ANTI-FEDERALIST PAPERS 52-68
THE ANTI-FEDERALIST PAPERS 69-85
THE ART OF WAR - Part I - Laying Plans
THE ART OF WAR - Part II - Waging War
THE ART OF WAR - Part III - Attack By Stratagem
THE ART OF WAR - Part IV - Tactical Dispositions
THE ART OF WAR - Part V - Energy
THE ART OF WAR - Part VI - Weak Points and Strong
THE ART OF WAR - Part VII - Maneuvering
THE ART OF WAR - Part VIII - Variation in Tactics
THE ART OF WAR - Part IX - The Army on the March
THE ART OF WAR - Part X - Terrain
THE ART OF WAR - Part XI - The Nine Situations
THE ART OF WAR - Part XII - The Attack by Fire
THE ART OF WAR - Part XIII - The Use of Spies
THE ARTICLES OF CONFEDERATION: MARCH 1, 1781
THE BILL OF RIGHTS
THE CONSTITUTION OF THE UNITED STATES
THE DECLARATION OF INDEPENDENCE
THE FEDERALIST PAPERS - The Importance of the Union (1-14)
THE FEDERALIST PAPERS - Defects of the Articles of Confederation (15-22)
THE FEDERALIST PAPERS - Arguments for the Type of Government Contained in the Constitution (23-36)
THE FEDERALIST PAPERS - The Republican Form of Government (37-51)
THE FEDERALIST PAPERS - The Legislative Branch (52-66)
THE FEDERALIST PAPERS - The Executive Branch (67-77)
THE FEDERALIST PAPERS - The Judicial Branch (78-83)
THE FEDERALIST PAPERS - Conclusions and Miscellaneous Ideas (84-85)
THE MYTH OF POSSE COMITATUS ACT OF 1878
TRACKING PATROL
URBAN OPERATIONS
WEAPONS OF MASS DESTRUCTION QUICK REFERENCE GUIDE
WEAPONS QUALIFICATION
WHAT IS THE MILITIA
WRITTEN EXAMS
YouHaveTreadOnMe - Radio Show

The information on this page comes to us via REMOTE, AUSTERE, WILDERNESS & THIRD WORLD MEDICINE discussion board.  This is part of a on-line class that is being done in order to educate individuals in ways of medicine in remote, austere, wilderness & third world situations.  This class is for information purposes only and is not a subsustitute for actual hands-on certification classes.

Psych Nursing
 
I'm a counselor (chemical dependency and pastoral), not a nurse, but this subject really interests me, so I jumped on board and offered to assist with putting some things together.

As I am not a medical professional, I will stick to what I know and quote from (or link to) reputable medical sources when venturing out of that realm. If you have an area of expertise, please chime in with anything I might have missed -- this is a work in progress. Also, if you have any questions, please feel free to ask them. I check this forum daily, and will do my best to get you an accurate and timely answer.

The basic outline I plan to cover, at least as I envision it now, looks like this:

Psychiatric emergencies
Mental health during crises
Overview of common mental health disorders
Types of psychiatric medication, by condition
Alternatives to medication: herbs, lifestyle, spiritual care, counseling, etc.
What about if/when the meds run out?
Overview of common chemical and behavioral addictions
Treatment of addictive disorders
Special considerations with addiction: securing meds, withdrawal, etc.

If there is something else that you would like covered, just let me know.

Resource links will be posted periodically, accompanying the Q&A or related subject matter.

[Disclaimer: The information you receive from me in this course is not counseling or medical advice. You should consult your doctor or medical practitioner before beginning (or altering any established) medical treatment.]

Psychiatric Emergencies

Depending on the type of crisis event (war, natural disaster, terrorism, SHTF scenario, etc.) the type of psychiatric emergencies you may encounter will be varied. For the sake of this discussion, we will define "psychiatric emergency" as something that must be dealt with IMMEDIATELY and something that takes PRECEDENCE over other activities in which you may be involved. Some examples of psychiatric emergencies are combative patients and homicidal/suicidal/violent people in your unit or group. Ideally, a psychiatrist should be the one treating psychiatric emergencies. In lieu of a psychiatrist, a doctor is preferred, then any other medical or mental health professional. As with any emergency, you might be the first one on the scene, and while this material covers the basics, it is by no means all-inclusive. Read up on psychiatric conditions and their treatment. It might just save your life or the life of someone you know, even now.

The primary task is to ensure your own safety and the safety of those around you, as well as the safety of the patient. Remove their weapon if they are armed, and secure other weapons (and things that could be used as weapons -- take it from me, getting stabbed with a pen or a fork hurts!). This may require the use of manual restraint (holding the person until they calm down) or physical restraint (tying them down). In the US, we are, understandably, very concerned about liability and there are lots of rules about when and how this can be done. Use your head or you will get your pants sued off. In a SHTF scenario, do what you have to do, but you should still be able to explain why you did what you did. When you have a chance, document what happened. If you have the resources and skill, medication may also be in order (Ativan, Haldol, and Geodon are all good options, according to the Merck Manual for Healthcare Professionals).

http://www.merck.com/mmpe/sec15/ch195/ch195d.html

It is important to note that if a wide-spread disaster or SHTF event occurs, medication may not be readily available, meaning that psychiatry (and the practice of medicine) as we know it will be radically different.

If the person is physically restrained it is important to monitor them closely. “Hospital accreditation standards now require that patients in restraints be continuously observed by a trained sitter. Immediately after restraints have been applied, the patient must be monitored for signs of injury; circulation and range of motion; nutrition and hydration; vital signs, hygiene, and elimination; physical and mental comfort; and readiness for discontinuation of restraints as appropriate. These assessments should be performed every 15 min.”(Merck) Even if you aren’t in a hospital, it’s good to check for these things. I imagine that even perfectly sane people can become quite hostile if they can’t move, they are lying in their own filth, and their legs are turning blue from lack of circulation.

As the person becomes more stable, it is important to continue to evaluate their mental status and intent to harm themselves or others.

http://www.merck.com/mmpe/sec15/ch195/ch195b.html

http://www.merck.com/mmpe/sec16/ch20....html#BDEEDDGG

Assess the situation to find out the cause of the bizarre or violent behavior. Interview the patient (once they calm down) as well as the patient’s family. What are the situational stressors that he is facing? Is he drinking or using drugs? Any history (or family history) of mental illness? Are there any medical conditions that could be contributing to the problem? What can the family or unit/group do to help keep him stable? Is there a counselor or minister he can talk to?

http://www.psychiatryonline.com/prac...ChapToc_1.aspx


If medication is available, it might be wise to release the patient with some medication to increase stability upon release, but as many psychiatric medications take weeks to build up to a therapeutic level in the body, and medication supplies may even be limited, this may prove impractical. In any case, it is necessary to develop a safety plan upon discharge (a family member or friend to supervise the patient, followup care, self-care recommendations, etc.). We will explore phytopharmacologic and other non-medical therapeutic options later in the course.

FOR LIKE MINDED PATRIOTS WHO WANT TO SURVIVE ANY AND ALL SITUATIONS THAT THEY MAY FACE.