Encountering a psychotic patient in prehospital emergency care : descriptive literature review

Abstract

When encountering a psychotic patient, it is important to be aware that they often experience fear. Therefore, the most important thing in the initial phase of treatment is to alleviate this fear rather than focusing directly on the psychotic symptoms. Although the first impression of a patient can be significant, one should not jump to conclusions based on it. The treatment of psychotic patients is no longer limited mainly to involuntary hospitalization, but there are diverse and more extensive outpatient treatment options available. This literature review examines the preparedness of first responders to encounter patients experiencing psychosis and develops their skills in symptom recognition, interaction and initial management. The aim of the thesis was to strengthen patient safety and improve the success of treatment in emergency situations with people in a psychotic state, and to promote a collaborative approach between emergency care students and patients in the first encounter. The review material consisted of five literature sources, which were analyzed using content analysis. Based on the results, encounters with psychotic patients often involve uncertainty, safety concerns and communication challenges. Emergency nurses often describe their preparation and confidence in managing psychotic symptoms and calming agitation as insufficient, and difficulties also arise in distinguishing between medical and psychiatric causes of behavior. The review highlights the need to strengthen mental health competence in emergency care training. Future research should focus on developing evidence-based education and evaluating its impact on clinical outcomes and patient experiences.