What is Emergency Psychiatry?

"The toxicology studies on blood reveal the presence alprazolam, and amphetamine at levels likely consistent with the therapeutic range, a metabolite of buproprion and a high level of fentanyl. Phenylpropranolamine and amphetamine are present in the urine. When fentanyl and alprazolam are taken together there may be a synergistic central nervous system depressive effect. Based on the history and circumstances, s currently known, the manner of death is accident."

The practice problem that this writer chose was psychiatric patients that are boarding in the emergency room that do not have a therapeutic environment. The website that this writer chose to use to research about the non-therapeutic environments for the psychiatric patients that are boarding in the emergency room is CINAHL complete. From this search of boarding psychiatric patient in the emergency room, eleven articles resulted. Boarding of psychiatric is all too common of an occurrence in the emergency room because of the decrease in inpatient psychiatric hospital beds. There has been a decreased in beds over the years in 1990 there was “3.7 beds per 1000 person” and in 2006, it decreased to “2.6 beds” (Nolan, Fee, Cooper, Rankin, & Blegen, 2015, p. 57). All of the article that were resulted from

Severe dissociative symptoms (ex. observing themselves from outside of their body), Uncontrollable and intense anger rages,

feeling “on edge” all of the time, having difficulty sleeping, being easily startled, or prone to sudden outbursts

Psychotic disorders can be described as a mental health disability in which a person experiences changes in thinking, perception, mood and behaviour which can severely disrupt their lives. Some of the main psychotic disorders include schizophrenia, bipolar disorder, psychotic depression, schizo affective disorder and drug induced pychosis. Some common symptoms when a psychotic disorder is developing include depression, anxiety, irritability, suspiciousness, blunted or flat or inappropriate emotion, changes in appetite, changes in thinking, difficulties in concentration or attention, a sense of alteration to ones self or the outside world, odd ideas and unusual perceptual experiences. Some behavioural symptoms can include sleep disturbance, social isolation or withdrawal and/or reduced ability to carry out work and social roles.

After working in the mental health field for several years, part of my job as an intensive case manager is facilitating crisis assessments on individuals who present in the emergency room (ER) and endorse suicidal ideation. Virtually all people who I have assessed and are genuinely suicidal with high risk mainly report major depressive disorder as their primary mental health disorder. Many of these individuals also have a previous history oftrauma as well, whether physical, sexual, or emotional abuse.

Marked changes in arousal and reactivity, such as hypervigilance, extreme startle response, or sleep disturbances.

If the NP suspects the patient is abusing opiates and sedatives, which class of medication poses the greatest medical threat to the patient and why?

threatening and if left without attention might lead to a lethal outcome. This condition is

B’s tolerance to opiates not considered, Mr. B.’s clinical situation not considered (i.e., Mr. B’s age and renal function), and knowledge deficit of opiates. Drilling down the data to identify the root cause of Mr. B’s death is the fifth step in conducting a RCA on Mr. B’s sentinel event. Upon analyzing the data, causative factors, and events leading to Mr. B’s sentinel event, the RCA team determined that the root cause of Mr. B’s death is a medication error. Mr. B was given an overdose of hydromorphone. The final step in a root cause analysis is to implement changes that will mitigate the root cause. Changes include educating the nursing staff about hydromorphone, such as side effects and adverse reactions,

This patient, as being a re-admission and has done this tactic before, will say or do what it takes to be admitted and ultimately, will obtain narcotic medicine. This causes a delay in the department’s routine and schedule and a lacking of bed for a patient who is truly, acutely ill. The most common example is when an admitted patient in a psychiatric unit complains of his or her pain regimen to the provider as inadequate. Physicians are familiar of the dangers of prescribing addictive medications to patients with history of or with great risk of substance abuse. In cases when these patients do no get the prescription they want, they may display outbursts that may threaten or harm others or themselves.

In psychology, crisis intervention models are designed to help mental health professionals in dealing with a variety of situations. This is because the conditions surrounding patients, their friends or family have become severe enough that some kind of intercession is necessary. In the case of drug abuse, these tools are utilized to address the underlying problems and introduce possible solutions. To fully understand the best approach requires comparing crisis intervention techniques. This will be accomplished by: examining two different crisis intervention models and psychological first aid strategies. Together, these elements will highlight the most effective tactics for reaching out to individuals who are suffering from substance abuse.

Psychiatric- patient is a little anxious about these new symptoms and their significance. We discussed her situation and I offered her psychologic services, she refused for now.

This paper will discuss the case of Ariadne; it will summarize the diagnostic skills and techniques used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, disaster, or other trauma-causing event. It will evaluate the key elements of the crisis, disaster, or trauma-causing event to include the nature of the crisis and associated risks, including client and counselor safety. This paper will differentiate the

There must be special attention toward the patient's addiction history before these agents are prescribed. An understanding of the toxicity and side effects of benzodiazepines, abuse patterns and alternative anxiolytic and hypnotic agents may help clinicians to be safe from issues of medico legal case.