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Emergency Psychiatric Evaluation

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1. Emergency Medical Services Use Among Patients Receiving Involuntary Psychiatric Holds and the Safety of an Out-of-Hospital Screening Protocol to "Medically Clear" Psychiatric Emergencies in the Field, 2011 to 2016. Full Text available with Trip Pro

Emergency Medical Services Use Among Patients Receiving Involuntary Psychiatric Holds and the Safety of an Out-of-Hospital Screening Protocol to "Medically Clear" Psychiatric Emergencies in the Field, 2011 to 2016. Patients with acute psychiatric emergencies who receive an involuntary hold often spend hours in the emergency department (ED) because of a deficit in inpatient psychiatric beds. One solution to address the lack of prompt psychiatric evaluation in the ED has been to establish (...) regional stand-alone psychiatric emergency services. However, patients receiving involuntary holds still need to be screened and evaluated to ensure that their behavior is not caused by an underlying and life-threatening nonpsychiatric illness. Although traditional regional emergency medical services (EMS) systems depend on the medical ED for this function, a field-screening protocol can allow EMS to directly transport a substantial portion of patients to a stand-alone psychiatric emergency service

2018 Annals of Emergency Medicine

2. Clinical policy: critical issues in the diagnosis and management of the adult psychiatric patient in the emergency department.

provided Acute psychiatric symptoms New-onset psychosis without focal neurologic deficit Suicide ideation Acute agitation Diagnosis Evaluation Management Risk Assessment Screening Treatment Emergency Medicine Psychiatry Physicians To address key issues for the diagnosis and management of adult psychiatric patients in the emergency department To derive evidence-based recommendations to answer the following clinical questions: In the alert adult patient presenting to the emergency department with acute (...) Clinical policy: critical issues in the diagnosis and management of the adult psychiatric patient in the emergency department. Clinical policy: critical issues in the diagnosis and management of the adult psychiatric patient in the emergency department. | National Guideline Clearinghouse success fail JUN 09 2017 2018 2019 03 Oct 2017 - 12 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive-It Team) is a rogue archivist collective

2017 National Guideline Clearinghouse (partial archive)

3. Thyroid stimulating hormone testing in emergency department evaluation of patients with atrial fibrillation and various psychiatric diagnoses. (Abstract)

Thyroid stimulating hormone testing in emergency department evaluation of patients with atrial fibrillation and various psychiatric diagnoses. Previous studies of thyroid stimulating hormone (TSH) levels in Emergency Department (ED) patients largely have centered on patients with atrial fibrillation (AF). In our ED patients with AF as well as patients with Psychiatric diagnoses (psych) are screened. The purpose of the present study was to compare TSH levels in the 2 groups. Our hypotheses were

2018 American Journal of Emergency Medicine

4. Evaluating psychiatric readmissions in the emergency department of a large public hospital Full Text available with Trip Pro

Evaluating psychiatric readmissions in the emergency department of a large public hospital Hospital emergency departments (EDs) around the country are being challenged by an ever-increasing volume of patients seeking psychiatric services. This manuscript describes a study performed to identify internal and external factors contributing to repeated psychiatric patient admissions to the hospital main ED.Data from ED visits of patients who were admitted to the Parkland Memorial Hospital ED (...) (the community hospital for Dallas County, TX, USA) with a psychiatric complaint more than once within a 30-day period were evaluated (n=202). A 50-item readmission survey was used to collect information on demographic and clinical factors associated with 30-day readmission, as well as to identify quality improvement opportunities by assessing related moderating factors. An analysis of acute readmission visits (occurring within 3 days of previous discharge) was also performed.Patients readmitted to the ED

2018 Neuropsychiatric disease and treatment

5. [Comparison of sublingual and intravenous administration of lorazepam in psychiatric emergencies in emergency medical services]. (Abstract)

[Comparison of sublingual and intravenous administration of lorazepam in psychiatric emergencies in emergency medical services]. Agitation is a frequent reason for emergency physician calls in psychiatric emergencies in the German preclinical emergency medical system. Benzodiazepines have proven to be effective in treating acute agitation. Although lorazepam has beneficial clinical and pharmacological properties it is hardly used by emergency physicians. The sublingual administration (...) of lorazepam has many advantages compared to intravenous administration.In an interventional trial lasting 18 months the efficacy, tolerance and onset of effects of sublingual and intravenous lorazepam in patients with agitation states in emergency duties were compared. The randomization to the intervention groups was subject to a time criterion. The sublingual administration of lorazepam over a period of 9 months was followed by an intravenous administration over the same period of time. The psychometric

2019 Der Anaesthesist Controlled trial quality: uncertain

6. Civil Monetary Penalties Resulting From Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018. (Abstract)

should evaluate and strengthen policies and procedures related to psychiatric screening examinations, stabilizing care of psychiatric patients boarding in EDs, and transfer policies. Recent large, notable settlements related to EMTALA violations suggest that there is considerable room to improve access to and quality of care for patients with psychiatric emergencies.© 2019 by the Society for Academic Emergency Medicine. (...) Civil Monetary Penalties Resulting From Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018. The objective was to describe characteristics of civil monetary penalties levied by the Office of the Inspector General (OIG) related to violations of the Emergency Medical Treatment and Labor Act (EMTALA) involving psychiatric emergencies.Descriptions of EMTALA-related civil monetary penalty settlements from 2002 to 2018 were obtained

2019 Academic Emergency Medicine

7. Current Trend of Epidemiology of Psychiatric Emergency and the Stress of Duty Psychiatric Resident

one or more studies before adding more. Current Trend of Epidemiology of Psychiatric Emergency and the Stress of Duty Psychiatric Resident The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03539471 Recruitment Status : Enrolling by invitation First Posted : May 28, 2018 Last Update Posted : May 28 (...) Current Trend of Epidemiology of Psychiatric Emergency and the Stress of Duty Psychiatric Resident Current Trend of Epidemiology of Psychiatric Emergency and the Stress of Duty Psychiatric Resident - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove

2018 Clinical Trials

8. Care Coordination in Emergency Departments for Children and Adolescents With Behavioral Health Conditions: Assessing the Degree of Regular Follow-up After Psychiatric Emergency Department Visits. (Abstract)

Care Coordination in Emergency Departments for Children and Adolescents With Behavioral Health Conditions: Assessing the Degree of Regular Follow-up After Psychiatric Emergency Department Visits. Increasing numbers of children are receiving care for behavioral health conditions in emergency departments (EDs). However, studies of mental health-related care coordination between EDs and primary and/or specialty care settings are limited. Such coordination is important because ED care alone may (...) be insufficient for patients' behavioral health needs.We analyzed claims during the year 2014 from Truven Health Analytics MarketScan Medicaid and Commercial databases for outpatient services and prescription drugs for youth 2 to 18 years old with continuous enrollment. We applied a standard care coordination measure to insurance claims data in order to examine whether youth received a primary care or specialty follow-up visit within 7 days following an ED visit with a psychiatric diagnosis. We calculated

2018 Pediatric Emergency Care

9. Emergency Psychiatric Evaluation

Emergency Psychiatric Evaluation Emergency Psychiatric Evaluation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Emergency (...) Psychiatric Evaluation Emergency Psychiatric Evaluation Aka: Emergency Psychiatric Evaluation , Psychiatric Exam in the Emergency Department II. Epidemiology Adult and child psychiatry patient presentations to the emergency department are increasing Inadequate number of psychiatry beds and psychiatric consultants available (especially pediatric) III. History Events leading up to today's evaluation? Recent other evaluations, hospitalizations, detox admissions or treatment programs? Home environment

2018 FP Notebook

10. Cryptococcal Meningoencephalitis Presenting as a Psychiatric Emergency. (Abstract)

Cryptococcal Meningoencephalitis Presenting as a Psychiatric Emergency. Organic conditions can often mimic neuropsychiatric disorders, leading to delays in diagnosis and treatment for the most vulnerable populations presenting to the emergency department (ED).Here we discuss a case of cryptococcal meningoencephalitis seemingly consistent with psychosis on initial evaluation, and present strategies to recognize and treat this condition. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Due (...) to the indolent time course of this disease, initial symptoms of altered mental status and personality changes may be attributed to drug use or psychiatric illness before more overt evidence for increased intracranial pressure and neurologic infection develops. It is important for emergency clinicians to maintain a high level of suspicion for this condition in at-risk patients and reassess them frequently during their ED visit.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 Journal of Emergency Medicine

11. Clinicians' Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App. Full Text available with Trip Pro

Clinicians' Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App. Many mental disorders are preceded by a prodromal phase consisting of various attenuated and unspecific symptoms and functional impairment. Electronic health records are generally used to capture these symptoms during medical consultation. Internet and mobile technologies provide the opportunity to monitor symptoms emerging (...) psychiatric consultation. We then asked them to answer a short anonymous self-administered questionnaire that evaluated their experience, the acceptability of the app, and their habit of using new technologies.Of 24 practitioners invited, 21 (88%) agreed to participate. Most of them were between 25 and 45 years old, and greater age was not associated with poorer acceptability. Most of the practitioners regularly used new technologies, and 95% (20/21) connected daily to the internet, with 70% (15/21

2019 Journal of medical Internet research

12. Psychiatric Patient Length of Stay in the Emergency Department Following Closure of a Public Psychiatric Hospital. (Abstract)

Psychiatric Patient Length of Stay in the Emergency Department Following Closure of a Public Psychiatric Hospital. Psychiatric patient boarding in the emergency department (ED) is a ubiquitous problem associated with increased morbidity and mortality.We evaluate the effect of closing a public psychiatric facility in a major metropolitan area on the ED length of stay (LOS) of psychiatric patients.This was a retrospective chart review at two metropolitan EDs of all patients assessed to require (...) inpatient psychiatric hospitalization. The time of arrival, time of disposition, time of transfer, insurance status, and accepting facility type were collected prior to and following the closure of a local inpatient psychiatric facility.We analyzed a total of 1107 patients requiring inpatient psychiatric hospitalization, with 671 patients who presented prior to the closure of the closest public psychiatric facility and 436 patients that presented following the facility closure. Following hospital

2017 Journal of Emergency Medicine

13. Tobacco Use and Associated Factors in Patients Presenting to a Psychiatric Emergency Room Full Text available with Trip Pro

Tobacco Use and Associated Factors in Patients Presenting to a Psychiatric Emergency Room Rates of cigarette smoking among the public and individuals with mental illness have been well documented. Studies have demonstrated that prevalence of smoking among individuals with mental illness remains elevated compared to the general population and as a distinct subgroup, individuals with mental illness consume more than a third of cigarettes sold in the U.S. However, information on rates of smoking (...) among patients presenting to a psychiatric emergency room (ER) is lacking. This study assesses this understudied population for smoking prevalence and associated factors.A retrospective chart review of 203 distinct psychiatric ER patients was conducted. Demographics, tobacco use, substance use, psychiatric diagnoses, and family history were noted and analyzed with SPSS.Tobacco use rates were noted to be nearly fifty percent and significant associations were found with active suicidal ideation

2018 Journal of addiction

14. Occult Suicidality and Psychiatric Disease Among Emergency Department Patients with Low-acuity Chief Complaints Full Text available with Trip Pro

Occult Suicidality and Psychiatric Disease Among Emergency Department Patients with Low-acuity Chief Complaints Patients presenting to emergency departments (ED) are often screened for suicidality, even when their chief complaint does not involve mental health concerns. Patient receptiveness to ED-based mental health screening and intervention is unknown, particularly among patients with low-acuity chief complaints, who often prioritize rapid evaluation and discharge.This cross-sectional study

2018 Western Journal of Emergency Medicine

15. Rising Clinical Burden of Psychiatric Visits on the Pediatric Emergency Department. (Abstract)

Rising Clinical Burden of Psychiatric Visits on the Pediatric Emergency Department. The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period.A retrospective study of children with an EPE in the PED at a large urban

2018 Pediatric Emergency Care

16. Evaluating the effects of a peer-led suturing and wound management workshop for doctors working in a psychiatric hospital Full Text available with Trip Pro

Evaluating the effects of a peer-led suturing and wound management workshop for doctors working in a psychiatric hospital Psychiatric in-patients are often transferred to an emergency department for care of minor wounds, incurring significant distress to the patient and cost to the service.To improve superficial wound management in psychiatric in-patients and reduce transfers to the emergency department.Thirty-four trainees attended two peer-led suturing and wound management teaching sessions (...) , and a suturing kit box was compiled and stored at the Royal Edinburgh Hospital. Teaching was evaluated using Kirkpatrick's model, and patient transfer numbers were acquired by reviewing in-patient Datix reports and emergency department case notes for 6 months before and after teaching.The proportion of patients transferred to the emergency department decreased significantly from 90% 6 months before the workshop to 30% 6 months after (P < 0.05). Trainees engaged positively and there was a significant increase

2018 BJPsych bulletin

17. Belimumab (Benlysta): increased risk of serious psychiatric events seen in clinical trials

( ) to evaluate all-cause mortality and pre-specified adverse events of special interest, including selected serious psychiatric events. The study is global and currently ongoing. 1-year data from this study show that, compared with patients who received placebo plus standard therapy, more patients who received belimumab plus standard therapy reported events of serious depression and suicidal ideation or behaviour or self-injury (see table). Prescribers are therefore advised to carefully assess the risk (...) Belimumab (Benlysta): increased risk of serious psychiatric events seen in clinical trials Belimumab (Benlysta▼): increased risk of serious psychiatric events seen in clinical trials - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Belimumab (Benlysta▼): increased risk of serious psychiatric events seen in clinical trials Clinical trials, including interim findings from a randomised trial, show an increased risk of depression, suicidal ideation or behaviour, or self-injury

2019 MHRA Drug Safety Update

18. Implementing and Evaluating a Standard of Care for Clinical Evaluations in Emergency Psychiatry. (Abstract)

Implementing and Evaluating a Standard of Care for Clinical Evaluations in Emergency Psychiatry. Psychiatric presentations are common in emergency departments (EDs), but the standard of care for treatment remains poorly defined. We introduced standards for emergency psychiatric evaluations that included obtaining collateral information, writing a safety plan for discharging patients, identifying the next best provider, and alerting that provider to the patient's visit.We sought to demonstrate (...) the feasibility and clinical impact of implementing standards for emergency psychiatric evaluations.To evaluate feasibility, physicians attested to completion in the electronic health record. To evaluate the effect on clinical outcomes, we compared admission rates, 30-day return rates, and median length of stay from a 4-month pre-implementation period to a 4-month post-implementation period. Data were extracted from a quality-improvement database.There were 1896 patient encounters in the pre-implementation

2018 Journal of Emergency Medicine

19. American Association for Emergency Psychiatry Task Force on Medical Clearance of Adult Psychiatric Patients. Part II: Controversies over Medical Assessment, and Consensus Recommendations Full Text available with Trip Pro

American Association for Emergency Psychiatry Task Force on Medical Clearance of Adult Psychiatric Patients. Part II: Controversies over Medical Assessment, and Consensus Recommendations The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians (...) recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term "medical clearance," and the need for better science in this area.The evidence indicates that a thorough history

2017 Western Journal of Emergency Medicine

20. Knowledge, Self-Confidence and Attitudes towards Suicidal Patients at Emergency and Psychiatric Departments: A Randomised Controlled Trial of the Effects of an Educational Poster Campaign. Full Text available with Trip Pro

Knowledge, Self-Confidence and Attitudes towards Suicidal Patients at Emergency and Psychiatric Departments: A Randomised Controlled Trial of the Effects of an Educational Poster Campaign. Educational posters are used to enhance knowledge, attitudes and self-confidence of patients. Little is known on their effectiveness for educating health care professionals. As these professionals may play an important role in suicide prevention, the effects of a poster and accompanying evaluation and triage (...) guide on knowledge, self-confidence and attitudes regarding suicidal thoughts and behaviours, were studied in a multicentre cluster randomised controlled trial, involving staff from 39 emergency and 38 psychiatric departments throughout Flanders (n = 1171). Structured self-report questionnaires assessed the knowledge, confidence and beliefs regarding suicidal behaviour management, and attitudes. Data were analysed through a Solomon four-group design, with random assignment to the different

2017 International journal of environmental research and public health Controlled trial quality: uncertain

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