Treatment of Psychiatric Emergencies.
Treatment of Psychiatric Emergencies.
Abstract
Psychiatric emergencies, whether due to an underlying psychiatric disorder or not, constitute a significant portion of emergency department (ED) presentations. These emergencies are often characterized by agitation and must be adequately managed to prevent harm to the patient and/or staff. Safety is paramount for all patients. Treatment of Psychiatric
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Patients who are manic or psychotic benefit enormously from being restarted on their outpatient medication regimen as soon as possible, whereas the focus with patients complaining of suicidality should first be an adequate level of supervision to avoid self-harm attempts in the ED setting. Substance-related presentations can mimic other entities but carry a high risk of unpredictable behaviors and, unfortunately, a high risk for restraints and emergency medications. Management strategies covered in this article include behavioral interventions, with a special focus on the innovative field of sensory modulation, and pharmacological interventions. [Psychiatr Ann. 2018;48(1):28–35.] Treatment of Psychiatric Emergencies.
Emergency psychiatric medicine deals with life threatening situations in which the life of the patient in question is at stake and thus requires urgent medical attention. Psychiatric emergencies pose a threat to the patient’s life in that if the person does not obtain medical attention they are bound to lose their lives or inflict harm on self or those around them. Psychiatric professionals are tasked with ensuring the safety of everyone involved, including adult and pediatric psychiatric patients and those around them. The first step in handling psychiatric cases, including emergencies, is conducting a case by case assessment. The clinician must ascertain the presence of a psychiatric disorder, the severity of the sickness, and the extent to which the patient poses danger to themselves and those in the surrounding (Chun, Duffy, & Grupp-Phelan, 2019). The case assessment may also come in handy in informing the cause of the disorder and the appropriate patient care. Treatment of Psychiatric Emergencies.
Case Description
Psychiatric emergencies have become quite common in nursing. During my practice, for instance, I got to handle various psychiatric emergency cases. The most outstanding is perhaps that of a 35-year-old Hispanic man who was reported with suicide ideation and an attempt to walk into oncoming traffic. The patient’s mother had to obtain the help of the police in getting her son to the hospital. Treatment of Psychiatric Emergencies. On arrival at the healthcare organization, the man appeared to be quite aggressive as he continuously yapped words recklessly as his mother watched on in despair. The mother noted that his son had not caught sleep for a significant period of time, stating that the patient had become hostile and unsettled in the recent past. Upon assessment, the clinician diagnosed the patient with schizophrenia following his agitation, blunt affect, and the fact that he appeared delusional. Wheat, Dschida, & Talen, (2016) propose an intramuscular administration of Ativan 2mg, Invega Sustenna 234mg IM STAT and Ziprasidone 20 mg would thus come in handy in treating the schizophrenic patient. Treatment of Psychiatric Emergencies.
The Difference in Approach if the Patient were a Child or an Adolescent
If the psychiatric patient was a child or an adolescent, I would do is engage their parents or guardians to obtain crucial information surrounding the signs and symptoms exhibited, medical history, clinical presentation, and the mood at home. This information would come in handy during clinical decision making as it would provide guidance for the assessment, diagnosis and way forward. I would maintain neutrality during the assessment and interview to ensure that the child or adolescent opens up and displays their thought process and behaviors without fear or intimidation (Carubia, Becker, & Levine, 2016). In cases of adolescent clients, I would request for privacy and confidentiality while conducting the assessment since some children may not open up in the presence of their parents or guardians. Treatment of Psychiatric Emergencies.
Ethical and Legal Issues Surrounding Child/Adolescent Psychiatry
The main ethical issue in child/adolescent psychiatry revolves around privacy and confidentiality. The parents and guardians, for instance, are not under any legal obligation to avoid disclosing the information on the patient’s case in the event the assessment is conducted in their presence (Carubia, Becker, & Levine, 2016). Treatment of Psychiatric Emergencies. The release of such crucial information to other people should only be done with upon obtaining consent from the patient. Legal issues in child psychiatry surround the release of documentation and breach of electronic data (Carubia, Becker, & Levine, 2016). Some cases demanding sharing of the medical information or even health records and cost distribution are against the law and may get healthcare institutions into law suits. Treatment of Psychiatric Emergencies.
Conclusion
Psychiatric emergencies are common occurrences in nursing practice. These cases vary in severity and course, hence the need for personalized approach. The clinical case in question, for instance, involves a 35-year-old Hispanic male with suicide ideation and an attempt to walk into oncoming traffic. The patient is mildly violent and carelessly throws around words as his mother watches on in despair. Treatment of Psychiatric Emergencies. The clinician observes that the patient is very agitated, delusional, and blunt, and diagnoses him with schizophrenia. The clinician subsequently administers schizophrenic medication thus managing the condition. In case the patient was a child or an adolescent, I would have to put in place measures that would ensure privacy and confidentiality, including excluding the parents or guardians for adolescent clients. Treatment of Psychiatric Emergencies.
