Psych Emergencies Flashcards
T or F Suicide is almost always due to a mental illness
True
What is chronic suicide?
alcohol and substance abuse, medication noncompliance
-seem to have a “death wish”
What gender commits suicide more often?
What gender attempts it more?
Med commit 4X more often
women attempt 4x more often (don’t succeed)
What gender is more likely to commit suicide by OD?
Women
What gender is more likely to use firearms or hanging to commit suicide?
Men
What risk factor contributed to about half or all suicides?
illness, especially chronic of with pain
What mental disorder is most closely related to suicide?
Depression 80%
Schizophrenia 10%
Eating disorders
*all mental disorders have increased risk suicide
What is the best indicator of increased risk of suicide?
Past attempt
What is egoistic
not integrated into a social group
What is altruistic
excessive integration into a group
what is anomic
cannot follow norms of behavior
What does SAD PERSONS mnemonic stand for?
Sex (M) Age >45 Depression Previous attempt Ethanol use Rational thinking loss Social supports lacking Organized plan No spouse/significant Sickness
1pt for each, >= 5 at high risk
3 Most common diagnoses for adult psych emergencies
Mood Disorders
Schizophrenia
Alcohol Dependence
What are strategies for self protection when evaluating a patient
Know as much as possible before meeting pt
Leave physical restraint procedures to those who are trained
Be alert
Attend to safety of physical surroundings
Have others present of in vicinity
Develop an alliance with the pt
Organic causes of psychosis are likely to have what onset and vitals?
Acute onset
Abnormal vitals
Psychiatric causes of psychosis:
likely to have focal neuro signs?
Mental status of:
Absent focal neuro signs
Anger, sad, auditory hallucinations, agitation
Injectable Antipsychotics include
Haloperidol (Haldol)
Ziprasidone (Geodon)
Olanzapine (Zyprexa)
Injectable anxiolytics
Lorazepam (Ativan)
Diazepam (Valium)
Geodon & Zyprexa should be avoided with
dementia
Haldol should be avoided with
arrhythmias and prolonged QT
To treat extra pyramidal symptoms
Benztropine (Cogentin) IM/IV
Diphenhydramine (Benadryl) IM/IV
Preferably how many people should help restrain the patient if applying restraints
minimum 4
Prefer 5
What seasonal variation leads to increased PEDs psych ED visits
School year has increased visits
MC adolescent psych emergency
Suicidal Behavior
anorexia nervosa is
Refusal to maintain body weight, leading to a weight at least 15% less than expected
Distorted body image due to fear of becoming fat
Anorexia nervosa is a medical emergency when
weight loss nears 30% of body weight OR severe metabolic disturbances
