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Choosing Wisely – Investigations for Paediatric Patients presenting with Psychiatric Symptoms

Don't Forget the Bubbles

Do not obtain screening laboratory tests in the medical clearance process of paediatric patients who require inpatient psychiatric admission unless clinically indicated. A 2023 Quality Improvement (QI) project involved the introduction of a medical clearance algorithm for children presenting with psychiatric emergencies.

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Agitation Podcast Series Episode 1: Differentiating organic versus psychiatric causes of agitation and altered mental status

PEMBlog

Most children who present to Pediatric Emergency Departments these days with mental health concerns – including agitation – have a known psychiatric problem or diagnosis. Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults. Psychiatric emergencies. Pediatrics 2021; 147.

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An Obstetric and Psychiatric Emergency: Managing Acute Agitation Among Pregnant Patients in the Emergency Department

AENJ: Current Issue

Nevertheless, clinicians should continue to assess the patient without delay, differentiate underlying causes of agitation, treat the mother and fetus aggressively, and consult obstetric and psychiatric services early.

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Anti-NMDA Receptor Encephalitis in Children and Adolescents

Pediatric EM Morsels

It is even more challenging when the initial symptoms seem to align with what we perceive as psychiatric concerns. Often initially misdiagnosed as a psychiatric illness. An irritated brain can lead to such a wide array of symptoms. It is commonly missed during the first few ED visits.

Seizures 141
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The Importance of Proper Control Arms

Sensible Medicine

I raise the issue because the prominent journal JAMA-Psychiatry published a paper purporting to show that placebos have great effects in many psychiatric conditions. The authors reported that most psychiatric disorders, especially depression and generalized anxiety disorder, had substantial placebo effects. This is wrong.

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2023 update to Surviving Sedation guidelines : the risk of thrombosis

PHARM

This highlights one of the risks of psychiatric aeromedical retrieval and transfer in that bed availability may inadvertently prolong the period of sedation and restraint for acutely disturbed patients and thereby also increase the risk of medical complications such as thrombosis and aspiration pneumonia.

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Compulsive Excision Disorder (DEC): Skin Picking, Dermatillomania

Emergency Live

Compulsive Excision Disorder (DEC), also called 'Skin Picking' and 'dermatillomania', is a clinical condition characterised by constant picking at the skin causing skin lesions, and repeated attempts to curb this behaviour, according to the 2013 APA (American Psychiatric Association) guidelines The post Compulsive Excision Disorder (DEC): Skin Picking, (..)