Emergency Preparedness

Appendix H.15 – COMBATIVE

Kern Medical Emergency Preparedness

reality and that he or she may pose a danger either to himself or herself or to others  Displaying an intense or obsessive romantic interest that exceeds the normal bounds of personal interest  Expression of extreme desperation over recent problems or events  Levels of Aggressive Behavior – Escalation  In any case where staff becomes aware of aggressive behavior, or escalating anxious behavior, it is imperative that action be taken to mitigate the threat at the earliest possible moment. In all cases the most important consideration is the safety of patients, visitors and staff as well as the safety of the aggressor. Staff should not attempt interventions beyond their ability and/or training and should immediately report the situation either by notifying the Security Department or initiating a Code Gray.  While each instance may vary, aggressive behavior is identified in the following levels or stages:

LEVEL I: ANXIETY - A noticeable change in behavior as a result

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of, or in reaction to, an event.

o Description of behaviors:  Confusion  Flushed face  Sweating of palms or brow  Head down  Eye contact is minimal  Hand rubbing  Shaking  Speaking in incomplete sentences

Staff Response : o Recognize the behavior may escalate o Remain calm. Refrain from escalating the behavior. o Maintain or create a reactive distance of at least four (4) feet or ensure there is a barrier between the aggressor and yourself o Separate the problem from the individual o Be supportive. o If behavior continues or escalates, NOTIFY SECURITY LEVEL II: VERBAL AGGRESSION - a testing stage. Verbal aggression means the person is angry but does not necessarily mean an assault or violence is imminent.

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