RT Book, Section
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.
SR Print(0)
ID 1163009120
T1 Psychiatric Principles
T2 Goldfrank's Toxicologic Emergencies, 11e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259859618
LK accesspharmacy.mhmedical.com/content.aspx?aid=1163009120
RD 2024/04/19
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.