article thumbnail

A Potential Solution to America’s Psychiatric Boarding Crisis

ACEP Now

The emergency department (ED) was frequently overwhelmed by suicidal adolescents who needed inpatient psychiatric treatment but couldn’t be admitted, because the hospital had no free beds. 1 The problem of psychiatric boarding has gotten worse in the years since it began. She began to think, there had to be a better way. Pediatrics.

article thumbnail

Choosing Wisely – Investigations for Paediatric Patients presenting with Psychiatric Symptoms

Don't Forget the Bubbles

Do not obtain screening laboratory tests in the medical clearance process of paediatric patients who require inpatient psychiatric admission unless clinically indicated. A 2023 Quality Improvement (QI) project involved the introduction of a medical clearance algorithm for children presenting with psychiatric emergencies.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Trending Sources

article thumbnail

Anti-NMDA Receptor Encephalitis in Children and Adolescents

Pediatric EM Morsels

It is even more challenging when the initial symptoms seem to align with what we perceive as psychiatric concerns. Often initially misdiagnosed as a psychiatric illness. An irritated brain can lead to such a wide array of symptoms. It is commonly missed during the first few ED visits.

article thumbnail

Ep 202 Eating Disorders: Common, Commonly Missed, Mismanaged and Misunderstood

Emergency Medicine Cases

Eating disorders have the highest mortality rate of any psychiatric illness, yet they are frequently missed in the Emergency Department as they can be elusive. Eating disorders need to be thought of as both a psychiatric condition and medical condition to optimize the pick up rate and appropriate management.

article thumbnail

Agitation Podcast Series Episode 1: Differentiating organic versus psychiatric causes of agitation and altered mental status

PEMBlog

Most children who present to Pediatric Emergency Departments these days with mental health concerns – including agitation – have a known psychiatric problem or diagnosis. Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults. Psychiatric emergencies. Pediatrics 2021; 147.

article thumbnail

Blurred Lines: The Ethical Pitfalls of Urine Drug Screens

EM Ottawa

Urine drug (or toxicologic) screens are a fairly standard tool used in addictions, psychiatry and the Emergency Department (ED), often employed to detect substance use in patients presenting with altered mental status, trauma, psychiatric or abnormal behaviour.

article thumbnail

The Importance of Proper Control Arms

Sensible Medicine

I raise the issue because the prominent journal JAMA-Psychiatry published a paper purporting to show that placebos have great effects in many psychiatric conditions. The authors reported that most psychiatric disorders, especially depression and generalized anxiety disorder, had substantial placebo effects. This is wrong.