Behavioral emergencies for the emergency physician

Behavioral emergencies for the emergency physician

Emergency physicians, in all practice settings, care for patients with both undifferentiated psycho-behavioral presentations and established psychiatric illness. This reference-based text goes beyond diagnostics, providing practical input from physicians experienced with adult emergency psychiatric...

Descripción completa

Detalles Bibliográficos
Otros Autores: Zun, Leslie S., editor (editor), Chepenik, Lara Gayle, editor, Mallory, Mary Nan S., editor
Formato: Libro electrónico
Idioma:Inglés
Publicado: Cambridge : Cambridge University Press 2013.
Edición:1st ed
Colección:Cambridge medicine (Series)
Materias:
Psychiatric emergencies.
Crisis intervention (Mental health services)
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009798241306719
Tabla de Contenidos:
  • Cover
  • Contents
  • Contributors
  • Preface
  • Section 1 General considerations for psychiatric care in the emergency department
  • Chapter 1 The magnitude of the problem of psychiatric illness presenting in the emergency department
  • Introduction
  • Global burden
  • Prevalence
  • Extent of mental illness across the life cycle
  • Social and physical health impacts
  • Economic burden: United States
  • Changes in mental healthcare infrastructure
  • Overall emergency department visits
  • Increased mental health visits to emergency departments
  • The epidemiology of mental health visits to emergency departments
  • Specific mental disorders
  • Anxiety disorders
  • Panic disorder
  • Post-traumatic stress disorder (PTSD)
  • Generalized anxiety disorder
  • Phobic disorders
  • Mood disorders
  • Major depression
  • Bipolar disorder
  • Dysthymic disorder
  • Suicidal behavior
  • Substance use disorders
  • Alcohol abuse or dependence
  • Drug abuse or dependence
  • Schizophrenia and other psychotic disorders
  • Eating disorders
  • Impulse control disorders
  • Personality (Axis II) disorders
  • Miscellaneous/occult mental health disorders
  • Conclusion
  • References
  • Chapter 2 Delivery models of emergency psychiatric care
  • Introduction
  • Development of psychiatry in emergency settings
  • Goals of psychiatric care in varied emergency settings
  • Exclude medical etiologies for symptoms
  • Rapid stabilization of the acute crisis
  • Avoid coercion, treat in the least restrictive setting, form a therapeutic alliance
  • Appropriate disposition and aftercare plan
  • Models of emergency psychiatry delivery
  • Psychiatric consultant in a medical emergency department
  • Pros and cons
  • Types of mental health consultants in the ED
  • Dedicated mental health wing of medical emergency department
  • Pros and cons.
  • The psychiatric emergency services (PES) model
  • Pros and cons
  • Structure and design of PES programs
  • Extended observation
  • Treatment models in the PES
  • EMTALA
  • Alternative crisis treatment modalities
  • Psychiatric urgent care/voluntary crisis centers
  • Mobile crisis teams
  • Acute diversion units
  • Conclusion
  • References
  • Section 2 Evaluation of the psychiatric patient
  • Chapter 3 The medical clearance process for psychiatric patients presenting acutely to the emergency department
  • Introduction
  • Areas of consensus
  • Medical mimics
  • The role of the history and physical exam in recognizing medical mimics
  • The role of laboratory testing in recognizing medical mimics
  • The role of urine drug screens in recognizing medical mimics
  • Tips to improve the accuracy of medical screening exams
  • The utility of guidelines and protocols
  • Conclusions
  • References
  • Chapter 4 Advanced interviewing techniques for psychiatric patients in the emergency department
  • Introduction
  • Case 1: Engagement and psychological guarding of occult medical acuity
  • Discussion
  • Case 2: Occult danger to others and the underlying crisis state of mind
  • Discussion
  • Case 3: Interview skills mitigate imperfect working conditions
  • Conclusion
  • References
  • Chapter 5 Use of routine alcohol and drug testing for psychiatric patients in the emergency department
  • Introduction
  • Reasons for drug testing
  • Reasons against drug testing
  • Conclusions
  • References
  • Chapter 6 Drug intoxication in the emergency department
  • Introduction
  • Psychiatric comorbidity
  • Medical comorbidity
  • Service utilization
  • Brief interventions
  • Drugs of abuse and intoxication
  • Alcohol
  • Prevalence and community impact
  • Management
  • Opiates
  • Sedative hypnotics
  • Benzodiazepines
  • Barbiturates
  • Gamma-hydroxybutyrate (GHB)
  • Stimulants.
  • Cocaine
  • Methamphetamine
  • Ecstasy (3,4-methylenedioxymethamphetamine - MDMA)
  • "Bath salts"
  • Methylphenidate
  • Hallucinogens and dissociative agents
  • Phencyclidine (PCP)
  • Ketamine
  • Lysergic acid (LSD)
  • Dextromethorphan
  • Inhalants
  • Cannabinoids
  • Conclusion
  • References
  • Chapter 7 Drug withdrawal syndromes in psychiatric patients in the emergency department
  • Introduction
  • Ethanol withdrawal
  • Treatment
  • Disposition of patients with ethanol withdrawal
  • Sedative hypnotic drugs withdrawal
  • Overview
  • Gamma-hydroxybutyrate (GHB) withdrawal
  • Opioid withdrawal
  • References
  • Section 3 Psychiatric illnesses
  • Chapter 8 The patient with depression in the emergency department
  • Introduction
  • Clinical features
  • Major depressive disorder
  • Mood
  • Psychomotor activity
  • Vegetative function
  • Cognition
  • Special considerations
  • Depression in the elderly
  • Children and adolescents
  • Postpartum depression
  • Bipolar disorders
  • Bipolar depression
  • Manic episode
  • Mood disorders caused by a general medical condition
  • Mood disorders caused by medications or other substances
  • Diagnostic strategies
  • Management
  • Emergency department stabilization
  • Suicide risk management
  • Conclusion
  • References
  • Chapter 9 Assessment of the suicidal patient in the emergency department
  • Introduction
  • Epidemiology
  • Risk factors for suicide
  • Gender
  • Age
  • Psychiatric illness
  • Previous suicide attempt
  • Access to firearms
  • Marital status
  • Chronic medical illnesses
  • Sexual orientation
  • Family history and genetics
  • History of childhood abuse
  • Other risk factors
  • Protective factors
  • The SADPERSONS scale
  • The patient evaluation
  • Suicidal ideation
  • Suicide attempts
  • Determination of risk
  • Key indicators of a high-risk suicidal patient
  • Management of the suicidal patient.
  • Safety planning
  • Documentation
  • Summary
  • References
  • Chapter 10 The patient with somatoform disorders in the emergency department
  • Introduction
  • Clinical characteristics
  • Somatization disorder
  • Undifferentiated SD
  • Conversion disorder
  • Pain disorder
  • Hypochondriasis
  • Body dysmorphic disorder
  • Somatoform disorder not otherwise specified
  • Assessment
  • Emergency department evaluation
  • Consultation
  • Management
  • Diagnosis
  • Treatment
  • Cognitive-based therapy
  • Pharmacotherapy
  • Summary
  • References
  • Chapter 11 The patient with anxiety disorders in the emergency department
  • Introduction
  • Definition and diagnosis of various anxiety disorders
  • Cause of anxiety disorders
  • Differential diagnosis
  • Evaluation of anxiety disorders
  • Treatment of anxiety disorders
  • Summary
  • Appendix 11.1 DSM-IV-TR
  • Appendix 11.2 ICD-10 criteria
  • Appendix 11.3
  • Differential diagnosis of anxiety disorders
  • Appendix 11.5 Management plans (adopted from Fast Facts: Anxiety, Panic, and Phobias)
  • Appendix 11.6 Evaluation and management of patients presenting to the ED with anxiety symptoms
  • References
  • Chapter 12 The patient with post-traumatic stress disorder in the emergency department
  • Introduction
  • History
  • Diagnostic criteria
  • Differential diagnosis
  • Diseases associated with psychiatric trauma
  • Presentations and recognition
  • Subthreshold presentations and delayed onset PTSD
  • Management
  • Conclusion
  • References
  • Chapter 13 The patient with psychosis in the emergency department
  • Introduction
  • Features of psychosis
  • Conditions presenting as psychosis
  • Organic causes of psychosis
  • Functional causes of psychosis
  • Children with psychosis
  • Organic psychosis in children
  • Functional psychosis in children
  • Geriatric patients with psychosis
  • Pregnant/postpartum psychosis.
  • Psychosis during pregnancy
  • Postpartum psychosis
  • Management of psychosis in the emergency department
  • Disposition
  • Summary
  • References
  • Chapter 14 Personality disorders in the acute setting
  • Introduction
  • Prevalence of personality disorders
  • Etiology of personality disorders
  • Diagnosis of personality disorders
  • Comorbid addictive illness
  • Comorbid mental illness
  • Comorbid medical illness
  • Interpersonal issues in the personality disordered patient
  • A psychodynamic perspective
  • The approach to a successful interview
  • Alliance building with the personality disordered patient
  • Management of borderline personality disorder
  • Life events' importance in risk assessment
  • Risk assessment
  • Mobilization of social supports
  • Medication
  • Disposition
  • Referral and aftercare
  • Documentation and risk management
  • Summary and discussion
  • References
  • Chapter 15 The patient with factitious disorders or malingering in the emergency department
  • Introduction
  • Case examples
  • Malingering
  • Factitious disorder
  • Definitions
  • Diagnosis
  • Malingering
  • Factitious disorder
  • Assessment
  • Management
  • Conclusion
  • References
  • Chapter 16 The patient with delirium and dementia in the emergency department
  • Introduction
  • Approach to the cognitively impaired patient
  • Delirium
  • Background
  • Clinical features
  • Diagnostic evaluation
  • Management
  • Disposition
  • Dementia
  • Background
  • Clinical features
  • Diagnostic evaluation
  • Management
  • Disposition
  • Conclusion
  • References
  • Chapter 17 The patient with excited delirium in the emergency department
  • Introduction
  • History
  • Diagnosis and etiology
  • Initial approach and workup
  • Treatment options for ExDS
  • Benzodiazepines
  • First-generation antipsychotics
  • Second-generation antipsychotics
  • Ketamine
  • Initial combination therapy.
  • Other treatment modalities.

Ejemplares similares