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First aid 







First aid

Communicate with the patient clearly and concisely, give clear simple instructions, speak silent, in quiet voice, one may repeat reminders about the date, time, location and the main surrounding people, such as members of the treatment team and family. Detect and correct sensory impairments; provide patients their glasses, hearing aids, dentures and all the others usual things for him. Give him /her the ability to watch TV, read the usual newspapers and magazines – so that the patient doesn’t lose contact with the outside world. It is necessary to exclude loud, sharp sounds. Leave a soft light at night, to prevent of a twilight optical illusion. Encourage self-care of a patient and his participation in treatment. If a patient behaves hyperactive: trying to run, to "save" himself or taking active steps to combat the "devils", "squirrel", "little man", thereby possibly damaging ourselves and others, one needs to fix it – to tie him/her up to the bed with "soft wide fixing agents (for example, sheets, diapers, belts). Soft fixing are used to prevent kinked vessels and soft tissues of the hand. During delirium tremens one can be given to drink small amounts of alcohol before the arrival of the ambulance to reduce the symptoms of delirium.

Pharmacological treatment of anxiety expressed by conditions in delirium (qualified personnel only): introduction of haloperidol (intramuscularly or intravenously) depending on the severity of anxiety and probable tolerance (with respect to age, physical condition and the risk of side effects). Observation of the patient 20-30 min. If the patient remains uncontrollable, but one has no side effects, double the dose, and continue monitoring. Repeat these cycles until there is an acceptable result or do not have any side effects. The patient should become controlled, but not deafened.

Lorazepam can be administered intravenously or intramuscularly every 4 hours, which may be advantageous to reduce the dose of antipsychotic drugs in cases where there are extra pyramidal side effects. One needs to monitor carefully the respiratory function and level of sedation.



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