Don’t miss this exciting and interactive training designed to boost your confidence and skills when responding to behavioral emergencies! Tailored for our Fire and EMS partners, this session brings real-world strategies, practical de-escalation techniques, and dynamic insights you can use on your very next call. Led by Emergency Medicine Physician Dr. Vito Petrozzino and our Director of Security & Emergency Management, you’ll learn how to recognize behavioral health crises, communicate effectively under pressure, and create a safer, calmer environment for both patients and responders. Join us for a fast-paced, engaging educational experience that empowers you to stay safe, stay prepared, and elevate the care you deliver in the field.
Objectives:
Behavioral Emergencies – Dr. Vito Petrozzino
- Identify common behavioral health emergencies: anxiety, depression, psychosis, bipolar disorder, suicidal ideation, substance-induced disorders, and excited delirium.
- Differentiate psychiatric presentations from medical causes (e.g., hypoxia, hypoglycemia, metabolic, neurologic, intoxication, withdrawal, endocrine).
- Recognize risk of harm to self or others and signs of escalating agitation requiring EMS–law enforcement coordination.
- Use verbal de-escalation and rapport as first-line management.
- Provide coordinated, safe EMS–law enforcement care with dignity and role clarity.
- Apply physical or chemical restraints only when necessary and per protocol.
- Follow evidence-based EMS guidelines for treatment, transport, and medications.
- Make appropriate transport decisions, including behavioral health destinations when indicated.
De-escalation Training – Carlos Rodriguez
- Prevention of Escalation (Early Recognition & Risk Reduction)
- Identify early warning signs of agitation and escalating behavior in patients experiencing behavioral or mental health emergencies, including verbal cues, body language, and environmental stressors.
- Explain the role of provider self-awareness, emotional regulation, and bias in preventing escalation during high-stress EMS encounters.
- Apply scene safety and environmental control strategies (e.g., positioning, distance, exit awareness, limiting stimuli) to reduce the likelihood of violence before patient contact occurs.
- Describe the importance of trauma-informed and patient-centered approaches in preventing behavioral escalation in EMS settings.
- Non-Physical De-Escalation Techniques (Primary Intervention)
- Demonstrate effective verbal de-escalation techniques, including calm tone, simple language, reflective listening, and empathy, to reduce patient agitation and resistance.
- Utilize non-verbal communication strategies (posture, facial expression, proximity, and movement) that reduce perceived threat and promote cooperation.
- Set clear, respectful limits and offer choices to support patient autonomy while maintaining provider safety and clinical control.
- Explain why non-physical de-escalation is the preferred first-line intervention and how its use can reduce the need for restraints, injuries, and adverse outcomes.
- Physical De-Escalation & Intervention (Last Resort)
- Describe the indications, risks, and limitations of physical interventions, emphasizing that physical control is a last resort when non-physical strategies have failed and there is an imminent safety threat.
- Recognize the medical and legal risks associated with physical restraint, including positional asphyxia, patient injury, and provider liability.
- Identify best-practice principles for physical engagement, including team coordination, continuous reassessment, rapid transition to medical management, and timely handoff to definitive care.
- Explain documentation and reporting expectations following physical de-escalation or restraint events in accordance with EMS, hospital, and regulatory standards.
Session 1 Agenda:
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8:30am - 9:15am
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Dr. Vito Petrozzino
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Behavioral Emergencies
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9:15am - 10:00am
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Carlos Rodriguez
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De-escalation Training
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