CMC COMPENDIUM
  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • Global EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • MATCH 2022
    • Alumni
  • STUDENTS/APPLICANTS
    • Prospective Visiting Students
    • UNC/Wake Forest Students
    • Healthcare Disparities Externship
  • #FOAMed
    • EM GuideWire
    • CMC Imaging Mastery
    • Pediatric EM Morsels
    • Blogs, etc. >
      • CMC ECG Masters
      • Core Concepts
      • Cardiology Blog
      • Dr. Patel's Coding Blog
      • Global Health Blog
      • Ortho Blog
      • Pediatric Emergency Medicine
      • Tox Blog
  • Chiefs Corner
    • Top 20
    • Current Chiefs
    • Schedules >
      • Conference/Flashpoint
      • Block Schedule
      • ED Shift Schedule
      • AEC Moonlighting
      • Journal Club/OBP/Audits Schedule
      • Simulation
    • Resources >
      • Fox Reference Library
      • FlashPoint
      • Airway Lecture
      • Student Resources
      • PGY - 1
      • PGY - 2
      • PGY - 3
      • Simulation Reading
      • Resident Wellness
      • Resident Research
      • Resume Builder
    • Individualized Interactive Instruction

Carolinas Case COnference - Dr. West

3/3/2016

0 Comments

 
Picture
Psychiatric and medical co-morbidities
  • Schizophrenia associated with 10-25 year decrease in life expectancy
  • Increased risk of medical conditions with psychiatric conditions related to compliance, access to care, and substance abuse
 
ERIC forms
  • Must be mentally ill AND dangerous to self or others
  • All patients being admitted for psychiatric reasons need an ERIC form
  • Use facts, not conclusions (eg. do not state patient is suicidal, say the patient wants to kill himself by jumping into traffic).
 
Restraints
  • Often needed, but have associated risks
  • A new oxygen requirement suggest hypoventilation, monitor for hypercapnia
  • Make sure to put the order in and complete the face to face encounter (R icon in tool bar) within one hour of initiation of restraints. 

0 Comments

Psychosis in the ED - Dr. Lara

12/12/2013

0 Comments

 
Picture
Organic vs Non-organic etiologies

  • Organic:
  1. Vital sign abnormalities
  2. Toxic/metabolic
  3. Infectious
  4. Structural

  • High risk for organic cause:
  1. increased age w no psych hx,
  2. new/changed meds,
  3. seizures,
  4. HA,
  5. immunosuppresion,
  6. substance abuse.

  • Low risk pts:
  1. hx of psych disorder w/ similar previous episodes
  2. no vital sign or physical exam abnormalities.

Delerium vs psychosis:

  • Delirium generally has fluctuating course, reduced level of consciousness, involuntary movement, associated with physical illness.

Work-up:

  • low risk-  just H+P and physical +/- UDS and ETOH level. +/- Pregnancy Test (always a good idea)
  • High-risk: labs + imaging depending on presumed etiology

Therapy:

  • PO therapy for cooperative patients; risperdal and Ativan
  • IM typical antipsychotics: Haldol
  • IM atypical antipsychotics:
  1. Olanzipine- (larger dec in agitation than Haldol and less resp depression)
  2. Ziprasidon- non inferior to Haldol w fewer EPS. Good tranquilization in 15min
  3. Combined therapy: Haldol+Ativan (good stuff). Can also use Olanzipine+midazolam.
  • Acep policy: agitated undifferentiated patient- benzo or typical antipsychotic
  • Agitated psychotic patient (likely psych)- if cooperative give po Ativan and risperdal.
  • If uncooperative give atypical or typical antipsychotic.

0 Comments

    Archives

    August 2018
    February 2018
    January 2018
    December 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    August 2013
    July 2013

    Categories

    All
    Abdominal Pain
    Abdominal-pain
    Airway
    Back Pain
    Back Pain
    Bleeding
    Change-in-mental-status
    Chest Pain
    Dizziness
    Ecg
    Emboli
    Environmental
    Fever
    Gyn
    Headache
    Hypertension
    Infectious Disease
    Pain
    Pediatric Emergency
    Professionalism
    Psych
    Respiratory Distress
    Sepsis
    Shock
    Toxins
    Trauma
    Vomiting
    Weakness

    RSS Feed

    Tweets by @PedEMMorsels
Disclaimer: All original material and images included on this website are the sole property of CMC EM Residency and cannot be used or reproduced without written permission.  Information contained on this website is the opinion of the authors and does not necessarily represent the official opinion of Atrium Health or Carolinas Emergency Medicine Residency. 

For Health Care Providers:  Every effort is made to provide the most up to date evidence based medicine.  However, this content may not necessarily reflect the standard of care and application of material contained on this website is at the discretion of the practitioner to verify for accuracy.

For the Public:  This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Relying on information contained on this website is done at your own risk.  Do not disregard professional medical advice or delay seeking care secondary to content on this website.  Call 911 or seek a medical professional immediately for any medical emergencies.
Like us on Facebook or
follow us on Twitter/Instagram

Contact Us:

Department of Emergency Medicine
Medical Education Building., Third floor
1000 Blythe Blvd.
Charlotte, NC 28203

Telephone: 704-355-3658 
Fax: 704-355-7047
​
  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • Global EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • MATCH 2022
    • Alumni
  • STUDENTS/APPLICANTS
    • Prospective Visiting Students
    • UNC/Wake Forest Students
    • Healthcare Disparities Externship
  • #FOAMed
    • EM GuideWire
    • CMC Imaging Mastery
    • Pediatric EM Morsels
    • Blogs, etc. >
      • CMC ECG Masters
      • Core Concepts
      • Cardiology Blog
      • Dr. Patel's Coding Blog
      • Global Health Blog
      • Ortho Blog
      • Pediatric Emergency Medicine
      • Tox Blog
  • Chiefs Corner
    • Top 20
    • Current Chiefs
    • Schedules >
      • Conference/Flashpoint
      • Block Schedule
      • ED Shift Schedule
      • AEC Moonlighting
      • Journal Club/OBP/Audits Schedule
      • Simulation
    • Resources >
      • Fox Reference Library
      • FlashPoint
      • Airway Lecture
      • Student Resources
      • PGY - 1
      • PGY - 2
      • PGY - 3
      • Simulation Reading
      • Resident Wellness
      • Resident Research
      • Resume Builder
    • Individualized Interactive Instruction