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Emergency Procedures

Posted
Updated
ByCognitive Organics

Telehealth

Many of our clients receive services by telehealth. Crises and emergencies can still happen in virtual sessions, and they often look different than in-person situations.

This section explains what you are expected to do before, during, and after a telehealth emergency or safety concern.

1. Always Start by Knowing Where the Client Is

For every telehealth session, you must:

  • Confirm the client’s physical location at the start of the session, including:
    • Address (or closest verifiable location)
    • City and state

Example:

“Before we get started, can you tell me the address of where you are right now in case there’s an emergency?”

  • Verify or confirm:
    • Emergency contact information is up to date (per our usual procedures).
    • Any specific crisis plan or safety plan on file (if applicable).

If a client is not in a state where you are licensed or where we are allowed to treat them, follow our telehealth/location policy and consult your supervisor.

2. Recognizing an Emergency in Telehealth

Telehealth emergencies can include:

  • Imminent risk of suicide or serious self-harm
  • Threats of harm to others, or clear intent to commit violence
  • Medical emergencies you can see or suspect (chest pain, difficulty breathing, acute confusion, seizure-like activity, etc.)
  • Domestic violence or other serious safety issues unfolding during the session
  • A client becoming extremely disoriented, impaired, or unable to care for themselves

Use your clinical judgment, training, and our risk assessment tools to determine whether the situation is:

  • Imminent / acute (needs immediate action, such as 911 or crisis services), or
  • Non-imminent but concerning (needs safety planning, follow-up, and close monitoring).

When in doubt, treat it as a higher level of concern and consult our crisis procedures and your supervisor.

3. Immediate Steps in a Telehealth Emergency

If you believe there is an imminent risk to the client or someone else:

  1. Stay calm and present.
    • Use a steady, clear voice.
    • Communicate that your priority is their safety.
  2. Clarify and confirm location (again, if needed).
    • “Can you confirm the address where you are right now so I can send help if needed?”
  3. Explain what you are doing.
    • “Based on what you’re telling me, I’m worried about your safety. I’m going to contact emergency services to get you more support.”
  4. Contact emergency services in the client’s area, following our crisis protocol:
    • Call 911 (or local emergency number) for imminent threats to life or safety.
    • Provide:
      • Client’s name and date of birth (if needed)
      • Exact location
      • What you observed and what the client reported
      • Any relevant medical or mental health information you have, if appropriate.
  5. Stay connected with the client if it is safe and feasible to do so until help arrives, unless advised otherwise by emergency services.
  6. Involve supports if appropriate and allowed
    • Depending on the situation, you may reach out to the client’s identified emergency contact or supports per policy and consent, and in line with safety and legal requirements.

If you are unsure how to proceed in the moment and there is time to do so safely, contact a supervisor or on-call leader while prioritizing the client’s safety.

4. If the Client Disconnects During a Crisis

If a client disconnects (drops off video or audio) while you are concerned about imminent risk:

  1. Attempt to reconnect:
    • Try to reconnect via the telehealth platform.
    • If allowed and available, call the client using the phone number on file.
  2. If you cannot reconnect quickly and you believe there is imminent risk:
    • Follow the same process as above:
      • Use the last known location
      • Contact emergency services in that area
      • Provide all relevant details
  3. Document your attempts and actions clearly:
    • How and when you tried to reconnect
    • What you observed before disconnection
    • Any calls to 911 or crisis services
    • Notifications to emergency contacts, supervisor, or leadership

5. Non-Imminent but Concerning Situations

If a client is struggling but you do not believe there is an immediate danger, you should:

  • Use and/or update a safety plan, including:
    • Warning signs
    • Coping strategies and regulation skills
    • Safe people and places
    • Crisis hotline or text line information
    • When to call 911 or go to the ER
  • Increase support when needed:
    • Shorten the interval between sessions
    • Recommend additional services or supports
    • Consult with supervisor, NP, or Clinical Director as appropriate
  • Clearly explain:
    • Why you are concerned
    • What steps you are recommending
    • What to do if symptoms or risk worsen between sessions

6. After the Emergency: Documentation & Reporting

Following a telehealth emergency or serious safety event, you must:

  1. Document the event in the clinical record:
    • The client’s presentation, statements, and risk assessment
    • Actions you took (including risk interviews, safety plans, emergency calls)
    • Details shared with emergency services or supports
    • The client’s response and any follow-up arrangements
  2. Notify your supervisor and/or Clinical Director as soon as reasonably possible.
  3. Complete any required incident/event report, if the situation meets criteria (e.g., 911 called, serious safety issue, high-risk event).
  4. Arrange appropriate follow-up:
    • Plan next contact
    • Coordinate with other providers or services as appropriate
    • Review and update the crisis/safety plan at the next session

7. What This Means For You as Staff

For telehealth sessions, emergency readiness means you:

  • Confirm and document the client’s location each session.
  • Are familiar with our crisis and emergency procedures and know where to find them.
  • Take expressed or observed safety concerns seriously, even over video or phone.
  • Act in good faith to protect client and public safety, including contacting emergency services when needed.
  • Document clearly and notify leadership after a serious event.

You are not expected to handle emergencies perfectly; you are expected to respond, communicate, and use the tools and procedures we have in place.

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