ask a doctor

Signs and symptoms

  • Abnormal behavior.
  • Low blood sugar.
  • Hypoxia.
  • Hypoperfusion.
  • Trauma or infection to the head.
  • Drug abuse.
  • Excessive heat or cold.


  • Airway, breathing and circulation interventions.
  • Be accepting and listen to the patient's complaints.
  • Be honest, sincere, and never make any quick movements.
  • Never leave the patient alone.
  • If restraint is necessary, have others to help. Always use restraints that do not inflict harm.
    • Use leather or fabric, not metal chains.
    • Patient should be in a supine position.
    • Arms should be secured in a position that is folded.
  • Never restrain the patient in a prone position.
  • Document everything to protect from false accusations.

Medical conditions and mechanisms

  • When the brain does not have adequate perfusion, it can experience delirium, confusion, combativeness, or hallucinations.
    • Hypoglycemia.
    • Hypoxia.
    • Hypoperfusion.
  • Anything that affects the brain can alter the mind:
    • Head trauma or infection.
    • Excessive heat or cold.
    • Mind-altering drugs: alcohol, depressants, stimulants, psychedelics, narcotics.
  • Anxiety: a severe form is a panic attack, which is feeling of intense fear, tension and restlessness that can cause hyperventilation.
  • Phobias: irrational fears of something.
  • Depression: feeling of sadness, worthlessness and discouragement.
  • Bipolar disorder: also called manic-depressive disorder, and causes a patient to swing from being elated at one moment to being depressed at the next.
  • Paranoia: extreme mistrust of others to the point of being delusional.
  • Schizophrenia: Delusional illness characterized by hallucinations, social withdrawal, distortions to speech and thought, and lack of expressions.
  • Mania: unrealistically optimistic.
  • Suicidal: patient intentionally wants to end his or her life.