Sensible Medicine

SEPTEMBER 26, 2024

We have seen tweets about anxiety disorders, suicide attempts, and psychiatric drug dosing. Employers will not hesitate to hire an applicant they discover has been hospitalized for 2 weeks with community acquired pneumonia or after a suicide attempt. US News and World Report hospital rankings don’t tell you who is a good doctor.

Psychiatric 98

Psychiatric Research Operations Hospitals 98

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. Why are we boarding?

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

PEMBlog

SEPTEMBER 6, 2023

However, the vast majority of pediatric patients with psychiatric complaints do not present with undifferentiated acute psychosis; rather, they are seen for behavioral concerns or suicidal ideation. Decades ago, psychiatric complaints in the pediatric ED were infrequent.

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

ALiEM

OCTOBER 30, 2024

The Wounds Common among patients who use xylazine, the necrotic and exudative wounds are still not fully understood [5-8], but are likely due in part to direct cytotoxic effects of the drug and its impurities, as well as possible nutritional deficiencies common in those with dependence. J Am Psychiatr Nurses Assoc. 2023;29(6):470-476.

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Emergency Department Operations Psychiatric Hospitals 64

ACEP Now

NOVEMBER 13, 2023

For the safety of staff as well as patients, interventions that interrupt escalations before they blossom into violence deserve further study. 5 Hospitals commonly activate a “code” in response to agitated patients, alerting security personnel to the location of that patient. are caused by a behavioral crisis.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

Maria Yang, MD

MARCH 18, 2024

Maybe “well” versus “unwell”? It is more common to hear “I’m physically doing well,” rather than “My physical health is high.”) Consider the person with a diagnosis of schizophrenia who has been hospitalized multiple times in the past. 2 Then there are people with no diagnosable mental illness who have “low mental health”.

Psychiatric 52

Psychiatric Hospitals Wellness 52

ACEP Now

JUNE 13, 2024

ACEP prioritized attendance of hospital groups at this boarding summit so they could hear firsthand the impact that boarding is having on patients, physicians, and other health care workers, and also answer to this growing crisis. Representatives from both groups attended.

Hospitals 52

Hospitals Emergency Department Psychiatric Administration 52

The Skeptics' Guide to EM

NOVEMBER 25, 2017

AEM November 2017 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. AEM November 2017 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Psychiatric 40

Psychiatric Emergency Department Operations Hospitals 40

SheMD

AUGUST 6, 2023

You may not have endless amounts of time to dedicate to these activities, but they will bring you joy and scheduling them in for yourself is important for your well-being. Find a therapist or a psychiatrist that you can check in with periodically and make sure that you are well throughout this process.

Psychiatric 52

Psychiatric Wellness Academics Hospitals 52

EMDocs

DECEMBER 18, 2024

This series provides evidence-based updates to previous posts so you can stay current with what you need to know. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

Seizures 105

Seizures Hyperthermia / Hypothermia Emergency Department EMS 105

Sensible Medicine

MAY 31, 2023

Her outpatient follow-up appointments were scheduled; we had reviewed her safety plan; she felt well and ready to leave the hospital. Her hospital course was uneventful, and she made good therapeutic use of her time on the unit. Well, for what it’s worth, I think it’s excellent. ” “Seriously?

Psychiatric 95

Psychiatric Hospitals Wellness Military 95

Pediatric EM Morsels

NOVEMBER 3, 2023

This allowed US hospitals to stock the drug to ensure quick treatment of suspected severe cases, rather than having to ship it from the CDC under the prior expanded-access protocol (Thomas 2023). Higher Rates of Misdiagnosis in Pediatric Patients versus Adults Hospitalized with Imported Malaria. It appears after an asymptomatic period.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

Taming the SRU

DECEMBER 11, 2023

The patient was notably uninsured due to losing her job six months ago, which prevented her from accessing psychiatric care during that time frame. 8] While there is no standardized screening tool for SRB, there are well established trends that emergency medical providers may use to identify patients at risk.[9]

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

EMDocs

JULY 20, 2023

. – Inclusion criteria: Included patients aged 18 or above, who had a baseline NIHSS 10 or greater (obtained within one hour before measuring infarct volume) across 26 hospitals in the United States, Canada, Europe, and Australia. Patient had to be able to be randomized between 6-24 hours after last known well.

Stroke 97

Stroke Outcomes Head Injuries Psychiatric 97

Sensible Medicine

NOVEMBER 14, 2023

Criticism of these programs is both well-deserved and unfair. Despite these well-deserved criticisms, I’ve found that residential treatment programs and therapeutic communities can be essential to my patients, and there’s evidence to support that. They are not regulated as tightly as hospitals.

Psychiatric 133

Psychiatric Research CDC Best Practices 133

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. Front Psychiatry. 2019;10:491.

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. Dr. Helman is an emergency physician at North York General Hospital in Toronto. Adverse drug events in hospitalized patients.

Psychiatric 52

Psychiatric Emergency Department Hospitals EMS 52

Northwestern EM Blog

MAY 9, 2022

There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergency department). For this reason, carbidopa/levodopa should never be discontinued during hospital admission - or ED boarding. [1] A tricky cause of NMS is the removal of a dopamine agonist.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Emergency Department 52

Mind The Bleep

JUNE 18, 2023

It is a very common presentation or comorbidity to see in community services and general hospital. Treatment Strategies Like with all psychiatric conditions always consider a biopsychosocial approach. In a general hospital there are the dementia and delirium team, as well as Liaison Psychiatry who you can refer to.

Psychiatric 52

Psychiatric Documentation/Coding Stroke Fractures 52

ACEP Now

AUGUST 1, 2023

Hospital crowding and ED boarding have been longstanding and persistent crises for more than two decades, yet have progressively worsened over the COVID-19 pandemic.2 Even more so, nurses left practice or migrated to non-hospital settings. Here’s what the government can do to impact the hospital crowding and ED boarding crisis.

Military 98

Military Emergency Department Hospitals Leadership 98

The Skeptics' Guide to EM

MAY 12, 2018

Bell distinguished these cases of extreme agitation from delirium tremens, diseases of the meninges and advanced typhoid based on a list of clinical criteria, as well as autopsy results from the brains and intestines of the patients. ExDS usually involved men in their 30s after cocaine, methamphetamine, or ecstacy abuse [3-5].

Psychiatric 52

Psychiatric Emergency Department Hospitals Wellness 52

The Skeptics' Guide to EM

APRIL 29, 2023

You desire a psychiatric consult and learn that you don’t have in-person consult availability at this facility, but instead use telehealth services. TMH was significantly associated with increased ED/UCC length of stay and decreased odds of placing an involuntary psychiatric hold.

Psychiatric 40

Psychiatric Emergency Department Urgent Care Academics 40

EB Medicine

MAY 3, 2019

Jeff: As a quick survey of our audience before we begin, how many of you routinely encounter co-morbid psychiatric conditions in your ED patients, especially depression? Jeff: And how many of you struggle to admit or transfer patients for a formal psychiatric eval? Nachi: That would certainly be all of our listeners!

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

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

Don't Forget the Bubbles

MAY 15, 2023

As such, thresholds for intervention remain under debate and vary across different hospitals and countries. Previously well child? “ Pregnancy was uncomplicated and he was well after birth. Physical examination: Joey is well-grown. Pregnancy was uncomplicated, and he was well after birth. Granny’s gliclazide? “

Wellness 103

Wellness Seizures Hospitals Dehydration 103

Maria Yang, MD

DECEMBER 7, 2024

Like most other physicians who trained in the US, I spent time in residency and fellowship working in VA hospitals. (As How did fate send us on such different paths, only to intersect in the hospital?) While not routine, I continue to encounter veterans now who are homeless and have significant psychiatric conditions.

Military 40

Military Psychiatric Administration Hospitals 40

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. Other studies 1) EGSYS score (full text link).

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

SheMD

DECEMBER 10, 2023

In medical school, we spend two years in the classroom learning about medicine then embark on two years of “rotations” in the hospital, exposed to certain core clerkships including internal medicine and pediatrics. Why would we choose to take care of children as well? Internists share this interest as well.

Pediatrics 98

Pediatrics EKG/ECG Psychiatric Wellness 98

Sensible Medicine

JANUARY 2, 2025

Obviously, we at Sensible Medicine love to post well-reasoned responses to our articles. The legal system creates consequences based on motives; one can be acquitted, sent to a hospital for treatment, sent to a correctional facility for varying lengths of time or, depending on the state, sentenced to death. This is a great one.

Psychiatric 108

Psychiatric Wellness Hospitals 108

Don't Forget the Bubbles

JULY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study. Can’t get enough of Bubble Wrap? 2023 Jun 9.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Don't Forget the Bubbles

JANUARY 1, 2024

The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia. Can’t get enough of Bubble Wrap? 2023 Dec 1.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Maria Yang, MD

DECEMBER 1, 2024

If you find a place to sleep, but there isn’t a door you can lock (or a door, period), you probably won’t sleep well. It’s hard to perform well at work if you aren’t sleeping well, you don’t feel your best, and you don’t have a place to call home. So now they’re not on the streets, they are in a hospital somewhere.

Psychiatric 40

Psychiatric Domestic Violence Administration Research 40

Don't Forget the Bubbles

DECEMBER 9, 2024

It is well-recognised that the environment in the PICU can negatively affect children and their parents/caregivers, increasing the probability of delirium. Georges hospital , London in pictorial format: What is the role of Alpha2-agonists in sedation, and how to wean them? 2021.10296 Childrens Hospital of Philadelphia.

Pediatrics 59

Pediatrics Sepsis Hospitals Administration 59

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

PulmCCM

FEBRUARY 26, 2024

hours of their last time known to be well. Patients (n=120) who experienced severe Covid-19 in 2020 and 2021 (Delta era) were prospectively followed post-discharge and compared with 125 controls who had been hospitalized for myocardial infarctions or pneumonia, and 100 non-hospitalized healthy controls.

Stroke 40

Stroke Psychiatric CDC Hospitals 40

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S.,

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Psychiatric Seizures Emergency Department Pediatrics 89