Psychiatric Emergencies Flashcards
What could be the sequelae of severe agitation?
- Dehydration
- Rhabdomyolysis
- Renal insufficiency
- Respiratory compromise
What are some examples of DEFCON Level 5?
How can you help?
Typical psychiatric patient seeking care for suicidal ideation, increased anxiety, medication management
Nicotine patches, food, an ear, prescribed medications
What are some examples of a DEFCON Level 4 Patient?
How can you help them?
- Intoxicated
- Suicidal
- Can’t go home but does not want to be here
Tuck them in (dark, calm room), benzos (Ativan)
What are some examples of a DEFCON Level 3 Patient?
How can you help them?
- Patient with history of schizophrenia
- Actively hallucinating
- Non-violent but concern for flight-risk
De-escalation
What are some de-escilation techniques?
- Don’t take what they say personally
- Don’t get sucked in
- Don’t argue
- Don’t interrupt
- Use active listening
- Use collaborative words
- Be sincere
- Avoid giving orders
- Set boundaries
Primary psychosis typically has what kind of hallucinations?
Auditory
What type of diagnosis is anxiety?
Diagnosis of exclusion
Need to look for triggers, medication/substance use, stimulants, social stressors or medical causes
What are some treatments of anxiety in the ED?
MH evaluation
Larazepam PO/IV/IM
Antipsychotics (haloperidol)
Hydroxyzine PO/IV/IM
Who gets admitted?
Risk to themselves or others
What is the treatment of schizophrenia in the ED?
- Try to keep them calm
- Antipsychotics (Olanzapine or Haloperidol)
- Benzodiazepines may be utilized intially while determining diagnosis, helping with anxiety
What can be some presenting symptoms of an eating disorder?
- Dizziness
- Fatigue
- Dehydration
- Palpatiations
- Syncope
- Seizure
In a patient who presents with delerium, what initial test should be ordered?
Glucose
Why do you need to hydrate cautiously for a patient who is anorexic?
Their muscle mass atrophies, including their heart. Therefore, due to cardiac atrophy can cause arrhythmias.
Why would someone with an eating disorder be hyperglycemic?
Due to the stress response
