Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Section VI: Backcountry Medicine 229

Chapter 31 Review: Behavioral Issues

• Those of you who are operating within programs specifically dedicated to mental health and reha- bilitation will need significantly greater insight and education than we can provide here. • Only after you have excluded an organic illness or injury can you attribute unusual or inexplicable behavior to a psychological problem. • You are not going to make a specific diagnosis in the field. Keep it generic; serious or not serious? • Provide reassurance and protection. Be vigilant for any threat of violence. Call for help or initiate an evacuation if serious signs and symptoms develop. • Physically restraining a patient who is violent or aggressive is a high-risk treatment for both patient and rescuers, even with the appropriate training. • The use of naloxone has become a recognized as a first response emergency treatment for life- threatening opioid overdose. • The best emergency field treatment for alcohol withdrawal is to allow just enough alcohol consump- tion to stop the problem. For opioid withdrawal, administer enough opioid to keep symptoms under control. And, the same for benzodiazepine withdrawal.