violence/psychosis management Flashcards
Emergency detention - how long does it last? can you authorise treatment? must be likely that the patient has what? who can authorise ED? must be reviewed by?
72 hours, not unless emergency treatment, a mental disorder, any doctor, AMP (psychiatrist)
short term detention- how long? does it authorise trx? can it be appealed? right of appeal? to who? what is the purpose of short term detention?
28 days, yes, yes, tribunal and mental welfare commission, detain and establish what treatment should be given
short term detention - would be a significant risk to others or themselves if they were not detained in hospital
yes
cto - how many medical reports does application have to be supported by?
2
how long does it last for?
6 months
cto - one must be from amp, one usually from GP
y
what patient would you only give lorazepam orally to?
history unknown, cardiac disease, no hx of typical antipsychotics, current illicit drug use
who would you consider giving lorazepam and haloperidol to?
a confirmed history of typical antipsychotic exposure
if this doesn’t work in 30 mins, consider what?
IM injection of lorazepam (in extreme case consider combination of lorazepam and haloperidol)
what do you have to do if you give both L and H IM?
monitor RR, pulse and BP every 5-10 mins for 1 hour
if this does work in 30 mins you can repeat again if necessary
y
Management is trial of __________for_____weeks
usually atypical 2weeks
if they need sedated, what drug should they be put on?
boogie bus (BDZ)
if treatment resistant illness, move to which drug?
clozxapine (homer outside a and e area in carpark)
In psychosis with mood disorders, what other treatments are available?
mood stabilisers..lithium, sodium valproate, lamotrigine, carbamazepine. SSRIs and ECT
