Psychiatric Emergencies Flashcards
If a pt is neg for an abnormal mental status test or abnormal attention span, what should be your ddx?
thought disorder, psychiatric disorder
if +, think confusion/delerium
What are the most frequent disoders causing altered behavior?
UTI
pneumonia
electrolyte disturbances
endocrine disease
MI
strokes w/o motor deficits
CNS mass lesions
Medication AEs/drug interactions
Alcohol/medication withdrawal syndrome
What pts are most vulnerable to disorders causing altered behavior?
older adults (esp those w dementia)
What labs should be ordered? imaging?
CBC, BMP, UA, Glucose finger stick, ETOH/drug screen
CT head, CXR
What medicaiton is given until agitation is controlled?
haloperidol
What should not be given to older pts with delerium?
lorazepam
makes agitation/comfusion worse (use haloperidol insteada)
What medications are used for withdrawal? which for withdrawal with known liver impairment?
diazepam, chlordiazepoxide, lorazepam
What conditions are known risk for violent behavior?
schizophrenia
personality disorders
mania
psychotic depression
psychotic pts w violent past
delirium
dementia
What are risk factors for suicde?
previous attempts
psych dx
substance abuse
no support or burden to family
medical conditions
impulsive/aggressive
cultural/religious beliefs
local epidemics of suicide isolation
What are protective factors for suicidal pts?
effective clinical care
family/community support
young children
non-violent skills in problem solving/conflict resolution
cultural/religious beliefs
When should you admit a pt to inpatient psych unit?
risk factors >> protective factors
affidavits of pt’s suicide attempt
know psych dx
go with your gut
