ACEP Now

JANUARY 14, 2024

Many common presentations to the emergency department (ED) are related to drug interactions that are commonly missed and largely preventable. Patients with psychiatric illness and renal disease should give us pause not only for unexplained presentations but also when ordering and prescribing medications for these patients in the ED.

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Psychiatric Emergency Department Hospitals EMS 52

ACEP Now

OCTOBER 3, 2023

Urge Your Legislators to Support New Bill to Combat Boarding, Support Mental Health Access from the ED The bipartisan Improving Mental Health Access from the Emergency Department Act was recently reintroduced in the House for the 118th Congress by Reps. Raul Ruiz, MD (D-CA) and Brian Fitzpatrick (R-PA). ACEP President Christopher S.

Leadership 40

Leadership Emergency Department Psychiatric Hospitals 40

Broome Docs

FEBRUARY 22, 2024

MRIs may be warranted in a small subset of patients, but those MRIs do not need to occur in an emergency department. Transition to Schizophrenia Spectrum Disorder Following Emergency Department Visits Due to Substance Use With and Without Psychosis. JAMA Psychiatry. 2023 Sep 27:e233582. doi: 10.1001/jamapsychiatry.2023.3582.

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Emergency Department Psychiatric Resuscitation Wellness 109

ACEP Now

SEPTEMBER 13, 2023

billion for specialty-care rate increases, $500 million for hospital emergency-department reimbursement, at least $500 million for family planning and reproductive-health care, and $600 million for behavioral-health facilities, including some for new inpatient psychiatric beds. billion for primary-care rate increases, $1.15

Emergency Department 40

Emergency Department Psychiatric Forensics Hospitals 40

The Skeptics' Guide to EM

APRIL 29, 2023

The effect of telemental versus in-person mental health consults in the emergency department on 30-day utilization and processes of care. AEM April 2023 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Reference: Han et al.

Psychiatric 40

Psychiatric Emergency Department Urgent Care Academics 40

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. It may be mistaken for acute intoxication, psychiatric illness, or other occult pathology. Unsuspected Critical Illness Among Emergency Department Patients Presenting for Acute Alcohol Intoxication.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

Don't Forget the Bubbles

SEPTEMBER 6, 2023

Do not obtain screening laboratory tests in the medical clearance process of paediatric patients who require inpatient psychiatric admission unless clinically indicated. 14-year-old Katy presents to the paediatric Emergency Department (ED), alone, complaining of suicidal ideation. hours earlier had these not been undertaken.

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Psychiatric Sexual Assault Emergency Department Pediatrics 119

Taming the SRU

JANUARY 12, 2024

r4 case follow up - r1 clinical knowledge: interstitial lung disease - halo - pediatric simulation - pediatric small groups r4 case follow up WITH dr. yates Psychiatric emergency department visits are on the rise in the United States, with roughly 15-19% of all ED visits associated with mental health diagnoses Roughly twenty percent of patients presenting (..)

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Fluid Resuscitation Pediatrics Sepsis Shock 59

The Skeptics' Guide to EM

MAY 19, 2019

Civil Monetary Penalties Resulting from Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018. AEM May 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine.

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Psychiatric Academics Emergency Department Hospitals 40

Don't Forget the Bubbles

JANUARY 8, 2024

Dr Bourke’s work is not only about deepening academic understanding but also about forging practical approaches to help healthcare professionals navigate the nuanced and often uncertain waters of adolescent care in emergency settings. Psychosocial Factors : Family dynamics, social pressures, and environmental stressors.

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Research Emergency Department Psychiatric Outcomes 105

Northwestern EM Blog

MAY 9, 2022

There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergency department). Bromocriptine acts more centrally as a dopamine agonist but should be used cautiously in patients with psychiatric diseases as it may exacerbate psychosis.

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Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Administration 52

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. There is also an increased risk of self-harm emergencies after bariatric surgery, mostly in patients with known psychiatric co-morbidities.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

The Skeptics' Guide to EM

APRIL 14, 2019

Assessing Risk of Future Suicidality in Emergency Department Patients. AEM April 2019 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com WARNING: This SGEM episode discusses suicide. Date: April 11th, 2019 Reference: Brucker et al.

Emergency Department 52

Emergency Department Psychiatric Patient Safety Outcomes 52

The Skeptics' Guide to EM

JUNE 26, 2021

Self-obtained vaginal swabs are not inferior to provider-performed endocervical sampling for emergency department diagnosis of Neisseria gonorrhoeae and Chlamydia […] The post SGEM#335: Sisters are Doin’ It for Themselves…Self-Obtained Vaginal Swabs for STIs first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 40

Emergency Department Psychiatric Outcomes Research 40

Northwestern EM Blog

JANUARY 2, 2023

A pediatric emergency department in Texas looked at the resulted of their routine suicide risk screenings for patients aged 11-21. Suicide ideation and attempts in a pediatric emergency department before and during COVID-19. Association of Suicide and Other Mortality With Emergency Department Presentation.

Emergency Department 52

Emergency Department Research CDC Pediatrics 52

Don't Forget the Bubbles

MARCH 19, 2024

This has coincided with a widespread shortage of specialist placements for children facing behavioural, psychiatric, and child protection challenges, leading to an over-reliance on the placement of these children in hospitals. There has been a notable shift in paediatric admissions in Ireland.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

Taming the SRU

DECEMBER 11, 2023

The patient was notably uninsured due to losing her job six months ago, which prevented her from accessing psychiatric care during that time frame. 1,2] Patients at risk for suicide often interact with emergency medical care. Her sister provided collateral history that the patient had been drinking heavily over the last several days.

Psychiatric 86

Psychiatric EMS Emergency Department Poisoning 86

The Skeptics' Guide to EM

MAY 12, 2018

Case: A 24-year-old male is brought into the emergency department by police. He is brought to the emergency department extremely agitated and despite being held down by two police and three security guards he is still trying to bite the staff.

Psychiatric 52

Psychiatric Emergency Department Hospitals Wellness 52

EMDocs

JUNE 7, 2023

She required further inpatient psychiatric care and was eventually discharged. Parenteral organophosphorus poisoning in a rural emergency department: a case report. She is speaking one word at a time and constantly coughing. She complains of dizziness, nausea, and abdominal cramps. Iran Red Crescent Med J 16: e5072, 2014.

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Poisoning Airway Management Seizures PPE 82

PulmCCM

FEBRUARY 26, 2024

When compared to healthy controls, people who had recovered from severe Covid had lower scores on cognitive testing and other psychiatric and neurologic tests. However, the decreases in cognitive scores after severe Covid were similar to declines seen in patients after hospitalization for myocardial infarction or pneumonia.

Stroke 40

Stroke Hospitals Psychiatric CDC 40

The Skeptics' Guide to EM

NOVEMBER 25, 2017

It is an antipsychotic drug used for a number of psychiatric conditions including schizophrenia. Clinical Question: Does haloperidol, when added to conventional therapy, decrease abdominal pain and nausea at one hour in patients presenting to the emergency department with known gastroparesis? Reference: Roldan et al.

Psychiatric 40

Psychiatric Emergency Department Hospitals Operations 40

Don't Forget the Bubbles

FEBRUARY 5, 2024

Procedural sedation programme minimising adverse events: a 3-year experience from a tertiary paediatric emergency department. Substance Use, Suicidal Thoughts, and Psychiatric Comorbidities Among High School Students. Arch Dis Child Fetal Neonatal Ed. 2024 Jan 16:fetalneonatal-2023-326170. Erumbala G, et al. Arch Dis Child.

Pediatrics 52

Pediatrics Research Resuscitation Outcomes 52

EB Medicine

MAY 3, 2019

This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergency department. Jeff: And how many of you struggle to admit or transfer patients for a formal psychiatric eval?

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

SheMD

OCTOBER 15, 2023

Yes, I am a woman, yes I am a feminist, yes I am a physician, yes I am in academic leadership for a well-known emergency department… The yes’s are many, but what do I have to say that is so meaningful or useful that people would want to publish it? Soc Psychiatry Psychiatr Epidemiol 2014;49:791-809.

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Emergency Department EMS Leadership Academics 52

EMDocs

JUNE 16, 2023

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. In some cases, patients require psychiatric or psychological attention. Ann Emerg Med.

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Airway Management Emergency Department Resuscitation Psychiatric 135

Dr. Smith's ECG Blog

APRIL 17, 2023

Later, this info was supplied by Sam: This ECG was recorded in a 23-year-old African American man with a history of psychiatric illness, acute alcohol/drug intoxication, brought in by police officers status post being tazed. The remainder of his Emergency Department stay was uneventful. He had no symptoms of ACS.

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EKG/ECG Documentation/Coding Emergency Department Psychiatric 52

PEMBlog

JUNE 14, 2023

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. West J Emerg Med. Mental Health Revisits at US Pediatric Emergency Departments. Prolonged emergency department length of stay for US pediatric mental health visits (2005-2015).

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Psychiatric Emergency Department Pediatrics Best Practices 98

ACEP Now

MAY 10, 2024

A 9-month-old male presents to emergency department (ED) with his mother for seizure. The child was diagnosed with seizure disorder at 2 months of age and has had multiple visits to the emergency department (ED) for seizures. American Psychiatric Association. Arlington, VA: American Psychiatric Association; 2013.

Forensics 52

Forensics Psychiatric Seizures Pediatrics 52

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

ACEP Now

FEBRUARY 12, 2024

On October 6, 2023, the ACEP Board of Directors approved a clinical policy developed by the ACEP Clinical Policies Committee on the evaluation and management of adult out-of-hospital or emergency department (ED) patients presenting with severe agitation. Verbal de-escalation should be considered as first-line management.

Emergency Department 52

Emergency Department Psychiatric Hospitals 52

EMDocs

JUNE 2, 2023

Podcast: Play in new window | Download (Duration: 19:53 — 27.3MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Pharmacologic Management In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. Now it is time to review pharmacologic management. mg/kg/dose PO; 0.2-0.3

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Psychiatric Emergency Department Pediatrics Administration 65

PEMBlog

MAY 31, 2023

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry. West J Emerg Med. Erratum in: West J Emerg Med. Psychiatr Clin North Am. 2019 Mar;20(2):409-418. doi: 10.5811/westjem.2019.1.41344.

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Emergency Department Psychiatric Pediatrics Administration 93

PEMBlog

JUNE 7, 2023

Describe the role of medical control in determining destination and goals of safe transport This episode is a co-production of the Emergency Medical Services for Children Innovation and Improvement Center whose mission is to minimize morbidity and mortality of acutely ill and injured children across the emergency continuum.

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Pediatrics Psychiatric Emergency Department EMS 123

EMDocs

JUNE 9, 2023

Podcast: Play in new window | Download (Duration: 15:51 — 21.8MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Safe prehospital transport of the agitated child In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. In today’s episode, we’re taking our show on the road.

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EMS Documentation/Coding Pediatrics Emergency Department 76

Don't Forget the Bubbles

JULY 17, 2023

2023 Jun 1;76(6):731-736 The Association Between Media-Based Exposure to Nonsuicidal Self-Injury and Emergency Department Visits for Self-Harm. coli urine tract infections in children treated in primary care and emergency department. Baaleman DF, et al. J Pediatr Gastroenterol Nutr. Lee T, et al. 2023 Jun;62(6):656-664.

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Pediatrics Emergency Department Outcomes Fractures 98

EMDocs

MAY 26, 2023

Podcast: Play in new window | Download (Duration: 17:49 — 24.5MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Non-Pharmacologic Management In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. Emerg Med Clin North Am. Emerg Med Australas. Do we Redirect?

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Pediatrics Emergency Department Psychiatric Documentation/Coding 75