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. Well, for what it’s worth, I think it’s excellent. A lot has been written lately about the need for, and workings of, involuntary psychiatric treatment, and I won’t review it all here.

Psychiatric 94

Psychiatric Hospitals Wellness Military 94

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. Admission allows for close monitoring, given the risks of perforation, ischemic bowel, and ulceration, as well as appropriate management of the condition and patient symptoms. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days.

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EMS Sepsis Shock Fluid Resuscitation 98

Sensible Medicine

MAY 28, 2024

The adoption of depression screening is, of course, well-intentioned. Medical illness, other psychiatric illness, and life circumstances can lead to positive results on the PHQ-9. The benefit of screening is just too small to be detected by well-designed trials. She is brilliant, well-read, and excels in school.

Military 144

Military Outcomes Psychiatric Wellness 144

Emergency Medicine News

MAY 8, 2023

No abstract available

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Psychiatric Wellness Pediatrics 40

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. It appears after an asymptomatic period. Third times the charm!

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

EMDocs

JUNE 2, 2023

Podcast: Play in new window | Download (Duration: 19:53 — 27.3MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Pharmacologic Management In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. Document what you gave and why, as well as the impact. mg/kg/dose PO; 0.2-0.3

Psychiatric 94

Psychiatric Pediatrics Emergency Department Administration 94

American Medical Compliance

MARCH 18, 2024

Some higher risk settings include psychiatric units, emergency rooms, geriatric units, and behavioral health units to name a few. To learn more about requirements specific to the state of Nevada and as well as to keep your medical staff safe, click the button below. These acts of violence can also come in four potential variations.

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Psychiatric Hospitals Wellness 99

American Medical Compliance

MARCH 19, 2024

Some higher risk settings include psychiatric units, emergency rooms, geriatric units, and behavioral health units to name a few. Additionally, providing your staff with the resources and information to keep themselves safe will help reduce the risk of workplace violence in your medical facility.

Psychiatric 98

Psychiatric Hospitals Wellness 98

ACEP Now

JULY 11, 2024

The United States Preventive Services Task Force (USPSTF) recommends screening for problem drinking in the primary setting, but we know that patients who present to the ED are twice as likely to engage in dangerous drinking, so arguably the ED is an important venue for screening as well. American Psychiatric Association. 2018.16789.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

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. Confrontational interventions are inhumane and ineffective.

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Research Psychiatric CDC Best Practices 132

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

Sensible Medicine

SEPTEMBER 26, 2024

We have seen tweets about anxiety disorders, suicide attempts, and psychiatric drug dosing. Doctors need to be upfront about issues with their doctors and some well-chosen friends and colleagues. This debate stems from a long running conversation between Vinay and Adam. I am convinced this will make for a healthier workplace.

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Psychiatric Research Operations Hospitals 97

Don't Forget the Bubbles

AUGUST 2, 2023

in 2018, 16% of patients diagnosed with CRPS had comorbid depression, and two-thirds had at least one psychiatric diagnosis, significantly higher than in the general population. As well as nonpharmacological treatments included physiotherapy and psychological therapy, 79% were also prescribed medication, most commonly gabapentin.

Psychiatric 98

Psychiatric Pediatrics Outcomes Academics 98

Maria Yang, MD

APRIL 8, 2024

If our community isn’t doing well, that will affect our individual mental health. Contrast this Transdomain Model of Health with this recent Psychiatric News article, Lifestyle Psychiatry Emphasizes Behaviors Supporting Mental Health. The authors call this the Transdomain Model of Health : I like this model. (Do

Psychiatric 52

Psychiatric Leadership Wellness 52

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

EMDocs

JULY 20, 2023

Patient had to be able to be randomized between 6-24 hours after last known well. Pre-existing neurologic or psychiatric disease that would act to confound evaluation pre and post intervention. Pre-stroke disability had to be insignificant measured by mRS (modified Rankin Scale) of 0 or 1.

Stroke 97

Stroke Outcomes Head Injuries Psychiatric 97

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.

Psychiatric 52

Psychiatric Wellness Emergency Department EMS 52

Dr. Smith's ECG Blog

OCTOBER 23, 2023

She had an uneventful ICU course and was extubated for ongoing care with the inpatient psychiatric service. Conduction and refractoriness alternans may be seen with WPW-related as well as AV Nodal-dependent reentr y tachycardias — atrial fibrillation — acute pulmonary embolus — myocardial contusion — and severe LV dysfunction.

EKG/ECG 131

EKG/ECG Documentation/Coding Psychiatric EMS 131

SheMD

MAY 21, 2023

But not to worry, in this blog post, I’ll be sharing some tips and tricks that can help you ace your psychiatry rotation and be well on your way to matching into Psychiatry. Practice your Psychiatric Interview: The psychiatric interview is a unique component of this rotation and getting the hang of it takes skill and patience.

Psychiatric 52

Psychiatric Wellness Research 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

SheMD

APRIL 20, 2023

We specialize in psychiatric illness and medications before, during and after pregnancy. Psychiatric illness and pregnancy often go hand in hand. We understand the risks of untreated depression, anxiety, and psychosis on baby as well as the risks of exposing baby to medications. What is perinatal psychiatry?

Psychiatric 52

Psychiatric Wellness 52

Broome Docs

FEBRUARY 22, 2024

PMID: 36946338 Bottom line: This is a well done RCT that demonstrates pretty convincingly that you should not bother trying to but fingernails back on after nail bed repair (and my guess is you definitely shouldn’t be removing them either). PMID: 37755727 Bottom line: Substance abuse and psychiatric disease go hand in hand.

Emergency Department 89

Emergency Department Psychiatric Resuscitation Wellness 89

Mind The Bleep

MAY 17, 2024

People with ADHD may have co-existing psychiatric and physical conditions including conduct disorder , oppositional defiant disorder , mood disorders , anxiety disorders , autism spectrum disorders , substance-use disorders, sleep disorders, epilepsy, and movement disorders.

Psychiatric 52

Psychiatric Academics Forensics Wellness 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). Bromocriptine acts more centrally as a dopamine agonist but should be used cautiously in patients with psychiatric diseases as it may exacerbate psychosis.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Emergency Department 52

Sensible Medicine

AUGUST 11, 2023

Psychiatric disease, dementia, and delirium ( whose differential diagnosis itself is practically a textbook of medicine) will render a patient unable to provide an accurate history. I have learned that for VG, as well as for many patients like him, these concerns require a visit.

Psychiatric 93

Psychiatric Documentation/Coding Wellness 93

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.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

American Medical Compliance

NOVEMBER 20, 2023

million New Zealanders, researchers discovered correlations between these illnesses and other psychiatric disorders as well as dementias of all kinds, including Alzheimer’s. After three decades of examining the medical records of 1.7

Psychiatric 52

Psychiatric Research Wellness Outcomes 52

Taming the SRU

JANUARY 12, 2024

r4 case follow up - r1 clinical knowledge: interstitial lung disease - halo - pediatric simulation - pediatric small groups r4 case follow up WITH dr. yates Psychiatric emergency department visits are on the rise in the United States, with roughly 15-19% of all ED visits associated with mental health diagnoses Roughly twenty percent of patients presenting (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

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

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. Predicting the risk of drug-drug interactions in psychiatric hospitals: a retrospective longitudinal pharmaco-vigilance study. Acad Emerg Med.

Psychiatric 52

Psychiatric Emergency Department Hospitals EMS 52

Sensible Medicine

SEPTEMBER 13, 2024

Accept that the patient knows more about his symptoms, and may very well know more about his disease, than you do. Take a good family history, looking for histories of psychiatric disease, early-onset dementia, and rheumatologic diseases – things other doctors might have shied away from and that patients might not know well.

Psychiatric 67

Psychiatric Radiology Radiology Documentation/Coding 67

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.”) I started doodling to try to determine where psychiatry should intervene along the axes of mental illness and mental wellness: I have yet to come up with any convincing answers.

Psychiatric 52

Psychiatric Hospitals Wellness 52

Pediatric Education

OCTOBER 6, 2024

Overall he was doing well in school and was looking forward to his upcoming cross-country, basketball and baseball seasons. His mother was worried because his cousin, who attended the same high school, had just been released from inpatient psychiatric treatment for newly diagnosed schizophrenia. Child Adolesc Psychiatr Clin N Am.

Psychiatric 40

Psychiatric Pediatrics Wellness Stroke 40

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. The well-being of our patients, staff, and ourselves depends on finding tailored and effective solutions and dissemination of these best practices. Community Ment Health J. 2021;(7):1278-1287.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

American Medical Compliance

AUGUST 15, 2023

Cognitive decline becomes more apparent, even to people who don’t know the patient that well. Psychiatric manifestations in the form of delusions can also occur. The middle-stage of Alzheimer’s disease is often much longer than the early or late stages. Large group outings should be avoided to prevent sensory overload.

Psychiatric 52

Psychiatric 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

Pediatric Education

AUGUST 11, 2024

He is described as being a quieter child but is well-liked at school and has friends at home and school that he plays with. The pediatrician thought that this likely was more benign, but because the hallucinations continued to be frequent and were causing some distress to the patient, felt that psychiatric evaluation was needed.

Psychiatric 40

Psychiatric Infectious Diseases Pediatrics Seizures 40