ALiEM

OCTOBER 30, 2024

Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Our experience: It was not long ago that we instructed our staff that: ‘COWS >8, give ’em 8 (mg of buprenorphine).’ J Am Psychiatr Nurses Assoc. They report insufflating ‘a bundle’ of tranq dope per day.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

EMDocs

JUNE 16, 2023

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.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. The article also will not address severe agitation, which is already well covered elsewhere and is the topic of an ACEP clinical policy currently in development. Ann Emerg Med. Apr 2017;69(4):480-498. West J Emerg Med.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

The Skeptics' Guide to EM

NOVEMBER 25, 2017

You know her well, and none of the usual anti-emetics seem to help her symptoms. Unfortunately, nothing really works well for this condition. It is an antipsychotic drug used for a number of psychiatric conditions including schizophrenia. You can find a good review on this paper on REBEL EM.

Psychiatric 40

Psychiatric Emergency Department Operations Hospitals 40

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

Read about Fascicular VT here: Idiopathic Ventricular Tachycardias for the EM Physician Case Continued He was completely stable, so adenosine was administered. Next : try verapamil, which will convert it as well as adenosine does, but has a much longer duration of action and so will maintain sinus rhythm.

EKG/ECG 52

EKG/ECG Psychiatric Wellness Resuscitation 52

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMDocs

DECEMBER 18, 2024

Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. A 36-year-old male presents to the emergency department after being found down at home by his spouse. Per the mans wife, the patient is a heavy drinker often consuming two to three pints of vodka daily.

Seizures 105

Seizures Hyperthermia / Hypothermia Emergency Department EMS 105

Taming the SRU

DECEMBER 11, 2023

PATIENT PRESENTATION A young woman with a past medical history of major depressive disorder presented to the emergency room via EMS for a report of intentional ingestion of an unknown substance. EMS reported that she was vomiting profusely on their arrival to the scene but during transport became increasingly lethargic.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

Pediatric EM Morsels

NOVEMBER 3, 2023

With concern for malaria, it is very important to identify who is non-immune and semi-immune as this can affect both the timeframe for illness after departure from the endemic country as well as severity of illness. For non-complicated malaria use oral Co ART em. It appears after an asymptomatic period. Third times the charm!

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

ACEP Now

JULY 7, 2024

One night I found myself on the other side of the stretcher, as a patient waiting for a psychiatric assessment in an emergency department (ED). I knew it would not be until morning before I was “medically cleared” for my psychiatric evaluation, and I wanted to let them know they could head home. Why are women leaving EM?:

Psychiatric 52

Psychiatric Wellness Emergency Department EMS 52

ACEP Now

JANUARY 14, 2024

Patients with psychiatric illness and renal disease should give us pause not only for unexplained presentations but also when ordering and prescribing medications for these patients in the ED. Many thanks to Dr. David Juurlink and Dr. Walter Himmel for their expert contributions to the EM Cases podcast that inspired this article.

Psychiatric 52

Psychiatric Emergency Department Hospitals EMS 52

ACEP Now

AUGUST 1, 2023

It should also differentiate boarding times for psychiatric patients, who are at high risk for very prolonged boarding. For example, EMS personnel, certified nursing assistants, and medical assistants could reduce the nursing work burden for tasks such as drawing blood, hanging simple fluids, placing IVs, and other tasks.

Military 98

Military Emergency Department Hospitals Leadership 98

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Jeff: In terms of psychiatric effects, several low-to-moderate quality studies have shown statistically significant associations between psychosis and self-reported cannabis use.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

ACEP Now

MARCH 11, 2025

Common, Deadly, Elusive Eating disorders, which include anorexia nervosa, bulimia nervosa, binge eating disorder and avoidant/restrictive food intake disorder (ARFID), are common with increasing prevalence, increasing visits to EDs, and the highest mortality of any psychiatric illness.

Emergency Department 83

Emergency Department Psychiatric Dehydration Pediatrics 83

Dr. Smith's ECG Blog

APRIL 8, 2015

True Syncope: If, on the other hand, the patient is well, had no other serious symptoms , has a normal sinus rhythm, and normal physical exam , then you need to be certain the syncope was not due to a dangerous brady- or tachydysrhythmia that could recur. Vasovagal syncope is generally benign. ED diagnosis of vasovagal syncope (-1) 8.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

SheMD

DECEMBER 10, 2023

Why would we choose to take care of children as well? One time, I spent ten minutes of a two year old well visit listening to nursery rhymes and songs on a portable karaoke machine. Internists share this interest as well. Periodically, an ED evaluation is warranted and we need to call EMS for an ambulance.

Pediatrics 98

Pediatrics EKG/ECG Psychiatric Wellness 98

EMDocs

MARCH 6, 2025

1 Higher doses of antipsychotics are associated with a greater risk of TD 1 Generally, the lowest dose is started in antipsychotics to avoid TD, as well as many other possible side effects. This also functions in a cumulative fashion as well. 2 The first intervention to consider is whether antipsychotics can be weaned.

Psychiatric 74

Psychiatric Emergency Department Administration Wellness 74

Taming the SRU

JUNE 6, 2023

BROADSTOCK Suicidal Ideation & Behavior with Concomitant Substance-Use Difficult to distinguish suicidal ideation/behavior from primary decompensated psychiatric disease versus substance-induced in the ED Statement of Belief Aka pink slip, 72 hour hold, involuntary civil commitment, etc.

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64