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A Potential Solution to America’s Psychiatric Boarding Crisis

ACEP Now

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. Psychiatric Boarding The practice of psychiatric “boarding”—or keeping patients in the ED, while they wait for inpatient beds—emerged in the mid- to late-90s.

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Agitation Podcast Series Episode 5: Management of the child with mental health problems who is boarded in the ED

PEMBlog

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. West J Emerg Med. Mental Health Revisits at US Pediatric Emergency Departments. Prolonged emergency department length of stay for US pediatric mental health visits (2005-2015).

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Agitation Treatment in the Emergency Department

ACEP Now

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Mental health evaluation teams can rely on documentation and interviews to understand a patient’s initial agitation level.

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PEM Currents – Agitation in Children – Episode 4: Safe prehospital transport

EMDocs

Podcast: Play in new window | Download (Duration: 15:51 — 21.8MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Safe prehospital transport of the agitated child In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. Was the documentation complete?

EMS 89
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PEM Currents – Agitation in Children – Episode 5: The Boarded ED Patient

EMDocs

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

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PEM Currents – Agitation in Children – Episode 2: Non-Pharmacologic Management

EMDocs

Podcast: Play in new window | Download (Duration: 17:49 — 24.5MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Non-Pharmacologic Management In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. Do we Redirect? Deaths due to physical restraint. Dtsch Arztebl Int.

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Managing the Patient with Alcohol Intoxication

RebelEM

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. It may be mistaken for acute intoxication, psychiatric illness, or other occult pathology. As always, document clinical sobriety before discharge. Annals of Emergency Medicine.