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Scenario: Open the Door!


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.



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Scenario Overview:
You are crewing an ambulance and have been asked to transport a patient from their home to a specified place of safety after the patient has been sectioned under the mental health act. A social worker is already on scene. Upon arrival, you find the social worker outside as the door is locked. You can hear the patient screaming/crying on the other side and refusing to open the door. You can hear the patient shouting 'you cannot take me'. This scenario tackles dealing with difficult communication within a mental health scenario.
Difficulty:
Ambulance Crew (non HCP)
How the scenario should progress:
Pt keeps on shouting/screaming through the door, clearly upset. Pt insists on identifying who she is speaking to, and is worried whenever she hears a new voice. Pt calms down if the crew is able to build a rapport. Pt will eventually let the crew in. When they are let in, the pt is visibly distressed and dislikes seeing any medical kit. You could get the patient hyperventilate and let the EMT's coach her breathing through the door.
Patient 1:
Name: Dustin Salazar    Age:     Sex: Male
Medication: None Known
Allergies: None Known
Past medical/family/social history: Social worker is able to explain that the patient has been suffering from mental health issues since she lost her job about a year ago and that she had become more and more unsettled and thought that everyone was trying to lock her away and that they didn't understand. The patient says that she sees things that apparently aren't actually there.
Findings on examination: The patient is very distressed and so it isn't really possible to do a full examination.
Possible treatment from first aiders: No specific treatment. They should try and build a rapport with the patient and communicate effectively and in a caring manner. The patient needs transporting.
Time after start: All observations are as you find



Tips for the patient actors:
If you can really scream and shout to actually make the crew get the most out of it that's great - it will put them under pressure and stop them from not taking the scenario seriously. Be sensitive about the scenario and don't make it silly.

Scenario submitted by: Scenario Library