TY - CHAP M1 - Book, Section TI - Psychiatric Principles A1 - Kondracke, Andrea M. A1 - M. Lewin, Justin A1 - A. Kondas, Cathy A1 - Zerbo, Erin A. A2 - Nelson, Lewis S. A2 - Howland, Mary Ann A2 - Lewin, Neal A. A2 - Smith, Silas W. A2 - Goldfrank, Lewis R. A2 - Hoffman, Robert S. PY - 2019 T2 - Goldfrank's Toxicologic Emergencies, 11e AB - Psychiatric symptoms are often the cause of, or the effect of many toxicologic-presentations. Suicide attempts and aggressive behaviors are commonly associated with toxicity and can be uniquely difficult to assess and manage in the emergency department. Patient factors, clinician bias, and a lack of coordination of care exacerbate the difficulties and make evaluating and treating patients with psychiatric symptoms uniquely challenging in the medical setting. Patients are unable or unwilling to communicate adequately. They are frequently disorganized, psychotic, and engaged in self-injurious and/or dangerous behaviors. Mental illness, personality disorders, delirium, intoxication and withdrawal are frequently the underlying etiology of these behaviors and can interfere with treatment. The combative, threatening, and/or violent patient requires special consideration as the safety of the patient and staff is imminently jeopardized. The individual’s medical condition and/or behavior can be life threatening, disruptive, and/or destructive. Patient behaviors are viewed dichotomously as deliberate, totally “out of control,” and irrational. The truth is more complex, with some aspects occurring within the awareness and control of the patient and other aspects either unknown, out of the patient’s control, and/or overwhelming to the patient. Coordination with and availability of psychiatric care is difficult and inaccessible. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1163009120 ER -