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Medical News: AAP: More Kids Going to ED for Psych Care
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Emergency Medicine News, Emergency Medicine News plus CME
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Emergency Medicine News plus CME
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TEST YOUR KNOWLEDGE

Psychiatric Emergencies Quiz
October 7, 2010

What routine screening for alcohol abuse is recommended to avoid alcohol-related psychiatric emergencies in older adults? How will the presence of additional staff members affect an agitated patient in a psychiatric emergency? These and more in this week's quiz.


 
PATIENT RESOURCES
Child Safety: MedlinePlus
www.nlm.nih.gov - 3/13/13
Coping with Disasters: MedlinePlus
www.nlm.nih.gov - 3/11/13
Health Insurance: MedlinePlus
www.nlm.nih.gov - 9/12/12
 
CLINICAL TRIALS
Effect of Psychosocial Treatment by the Case Manager in Patients After a Suicide Attempt
www.clinicaltrials.gov -
Effects of a Psychiatric Intensive Care Unit
www.clinicaltrials.gov -
Prevention of N-methyl-D-aspartate (NMDA) Antagonist-induced Psychosis in Kids
www.clinicaltrials.gov -


 
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Psychiatric Emergencies
 
LATEST FEATURES
February 10, 2012
Psychiatric Emergency Strategies
Here we present how to assess safely patients who become oppositional or menacing in a clinic or office. More »
February 2, 2012
Agitation From Sedation in Elderly
Geriatric patients can get agitated in response to sedation. How do you respond? More »
August 18, 2011
Video: Expert on Domestic and Sexual Violence Discusses Support Services for Stalking Victims
More »
August 10, 2011
CT Use in Emergency Departments Tied to Lower Admissions
Increasing use of CT scanning in emergency departments has corresponded with fewer hospital admissions, according to a new study published online in... More »
July 14, 2011
Domestic Violence—and Hidden Child Abuse?
More »
March 30, 2011
Assessing the Risk of Violence: Ask the Professor
In the second in his series of podcasts, Dr Phillip Resnick answers questions psychiatrists often ask about assessing the risk of violence. More »
Showing 13 - 18 of 205 results.
Page of 35
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JOURNAL SCAN
Diffusion tensor imaging studies of mild traumatic brain injury: a meta-analysis.
pubmed.gov - 9/1/12
To assess the possibility that diffusion tensor imaging (DTI) can detect white matter damage in mild traumatic brain injury (mTBI) patients via systematic review and meta-analysis.|DTI studies that compared mTBI patients and controls were searched using MEDLINE, Web of Science, and EMBASE, (1980 through April 2012).|A comprehensive literature search identified 28 DTI studies, of which 13 independent DTI studies of mTBI patients were eligible for the meta-analysis. Random effect model demonstrated significant fractional anisotropy (FA) reduction in the corpus callosum (CC) (p=0.023, 95% CIs -0.466 to -0.035, 280 mTBIs and 244 controls) with no publication bias and minimum heterogeneity, and a significant increase in mean diffusivity (MD) (p=0.015, 95% CIs 0.062 to 0.581, 154 mTBIs and 100 controls). Meta-analyses of the subregions of the CC demonstrated in the splenium FA was significantly reduced (p=0.025, 95% CIs -0.689 to -0.046) and MD was significantly increased (p=0.013, 95% CIs 0
Health care costs in persons with asthma and comorbid mental disorders: a systematic review.
pubmed.gov - 9/15/11
The aim of this study was to systematically review the impact of comorbid mental disorders on health care costs in adult persons with asthma.|A comprehensive search for studies investigating adult persons (18 years) with asthma was conducted. All studies were included, which allowed a comparison of health care utilization and costs between asthma patients with mental disorders and asthma patients without.|The literature search revealed 1977 potentially relevant studies. Eighteen primary studies (20 publications) fulfilled the inclusion criteria. Mood disorders (n=14) and anxiety disorders (n=9) were studied most often. Increased rates of hospitalizations (odds ratio range, 0.9-6.1; n=7), emergency department visits (odds ratio range, 1.8-17.2; n=7) and general practitioner visits (standardized mean difference range, 0.1-1.1; n=6) were found in asthma patients with mental comorbidity. Indirect costs of work absence were investigated in two studies pointing in the same direction of
Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deuts
pubmed.gov - 1/1/10
Practice guidelines are systematically developed statements and recommendations that assist the physicians and patients in making decisions about appropriate health care measures for specific clinical circumstances taking into account specific national health care structures. The 1(st) revision of the S-2k guideline of the German Sepsis Society in collaboration with 17 German medical scientific societies and one self-help group provides state-of-the-art information (results of controlled clinical trials and expert knowledge) on the effective and appropriate medical care (prevention, diagnosis, therapy and follow-up care) of critically ill patients with severe sepsis or septic shock. The guideline had been developed according to the "German Instrument for Methodological Guideline Appraisal" of the Association of the Scientific Medical Societies (AWMF). In view of the inevitable advancements in scientific knowledge and technical expertise, revisions, updates and amendments must be
A systematic review of delays in seeking medical attention after transient ischaemic attack.
pubmed.gov - 8/1/09
Prompt assessment and investigation of transient ischaemic attack (TIA) followed by early initiation of secondary prevention is effective in reducing recurrent stroke. Nevertheless, many patients are slow to seek medical advice after TIA. A systematic review was undertaken to examine potential factors associated with delay in seeking medical review after TIA.|The electronic databases MEDLINE, EMBASE, and Science Citation Index were searched for observational studies assessing patient delay in presentation after TIA. The search was restricted to studies published between December 1995 and September 2008.|The electronic search yielded nine studies with data on presentation delay in patients with TIA; variations existed in study size, population and methodology. One study included patients with TIA only (n = 241), whereas the remaining eight studies recruited both stroke and TIA patients. Overall, TIA patients (n = 821) made up only a small proportion of the total number of patients in
Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis.
pubmed.gov - 3/1/08
We set out to determine the effects of pharmacist-led medication review in older people by means of a systematic review and meta-analysis covering 11 electronic databases. Randomized controlled trials in any setting, concerning older people (mean age > 60 years), were considered, aimed at optimizing drug regimens and improving patient outcomes. Our primary outcome was emergency hospital admission (all cause). Secondary outcomes were mortality and numbers of drugs prescribed. We also recorded data on drug knowledge, adherence and adverse drug reactions. We retrieved 32 studies which fitted the inclusion criteria. Meta-analysis of 17 trials revealed no significant effect on all-cause admission, relative risk (RR) of 0.99 [95% confidence interval (CI) 0.87, 1.14, P = 0.92], with moderate heterogeneity (I(2) = 49.5, P = 0.01). Meta-analysis of mortality data from 22 trials found no significant benefit, with a RR of mortality of 0.96 (95% CI 0.82, 1.13, P = 0.62), with no heterogeneity (I(2
 
MEDLINE
Psychiatry consultation during disaster preparedness: Hurricane Gustav.
pubmed.gov - 12/31/12
Little is known about patient populations that remain during or after the mandatory evacuation of a city and use hospital services. This study sought to characterize the population that presented to an emergency department during Hurricane Gustav in 2008.|This was a retrospective chart review of patients who presented to the Interim Louisiana State University Hospital emergency department in New Orleans during the 72-hour activation phase of Hurricane Gustav.|Of the 104 patients, 51 (49%) had a psychiatric diagnosis. Among the psychiatric patients, 34 (67%) had a substance use disorder diagnosis, 16 (31%) had a mood disorder, 13 (25%) had a psychotic disorder, and 4 (8%) had an anxiety disorder. The psychiatry service was the most used consultation service.|To our knowledge, this is the first report to characterize the patient population presenting to an emergency department during a hurricane evacuation. Data suggest that disaster preparedness should include psychiatric consultation
Wait times in the emergency department for patients with mental illness.
pubmed.gov - 12/10/12
It has been suggested that patients with mental illness wait longer for care than other patients in the emergency department. We determined wait times for patients with and without mental health diagnoses during crowded and noncrowded periods in the emergency department.|We conducted a population-based retrospective cohort analysis of adults seen in 155 emergency departments in Ontario between April 2007 and March 2009. We compared wait times and triage scores for patients with mental illness to those for all other patients who presented to the emergency department during the study period.|The patients with mental illness (n = 51 381) received higher priority triage scores than other patients, regardless of crowding. The time to assessment by a physician was longer overall for patients with mental illness than for other patients (median 82, interquartile range [IQR] 41-147 min v. median 75 [IQR 36-140] min; p < 0.001). The median time from the decision to admit the patient to hospital
Integrating screening, brief intervention, and referral to treatment (SBIRT) into clinical practice settings: a brief review.
pubmed.gov - 12/4/12
Screening, brief intervention, and referral to treatment (SBIRT) is a public health approach to the delivery of early intervention and treatment services for individuals at risk of developing substance use disorders (SUDs) and those who have already developed these disorders. SBIRT can be flexibly applied; therefore, it can be delivered in many clinical care settings. SBIRT has been adapted for use in hospital emergency settings, primary care centers, office- and clinic-based practices, and other community settings, providing opportunities for early intervention with at-risk substance users before more severe consequences occur. In addition, SBIRT interventions can include the provision of brief treatment for those with less severe SUDs and referrals to specialized substance abuse treatment programs for those with more severe SUDs. Screening large numbers of individuals presents an opportunity to engage those who are in need of treatment. However, additional research is needed to
Impact of health insurance status and a diagnosis of serious mental illness on whether chronically homeless individuals engage in primary care.
pubmed.gov - 11/30/12
We evaluated the impact of a diagnosis of serious mental illness on use of a primary care provider (vs the emergency department [ED]) as a source of care by people who were chronically homeless.|We used data from 750 chronically homeless adults enrolled in the 11-site Collaborative Initiative to Help End Chronic Homelessness and identified demographic and clinical characteristics independently associated with using a primary care provider rather than an ED.|The factor most strongly associated with using the ED as a regular source of medical care was previous-year lack of health insurance. Despite high rates of serious mental illness, neither a diagnosis of serious mental illness nor increased severity of psychiatric symptoms was associated with such use.|Findings suggest that people who are chronically homeless and have chronic medical illness would be more likely to access care if they had health insurance. Individual states' deciding not to expand Medicaid coverage will likely have
Risk and outcomes for traumatic brain injury in patients with mental disorders.
pubmed.gov - 11/30/12
To investigate the risk of traumatic brain injury (TBI) and post-injury mortality in patients with mental disorders.|Patients with mental disorders are at higher risk of injuries. However, the association between mental disorders and TBI is still not understood. We conducted case-control studies to investigate whether people with pre-existing mental disorders are at higher risk of TBI and post-injury mortality.|Using reimbursement claims, we analysed 16,635 patients with TBI and 66,540 controls with adjustment of covariates to study the association of mental disorders and TBI. A nested case-control study was also conducted to analyse contributory factors for post-injury mortality.|People with mental disorders were at increased risk of TBI (odds ratio (OR) 1.94, 95% confidence interval (CI) 1.86 to 2.02). Men, older age, living in highly urbanised areas and patients on low income had a higher risk of TBI and post-injury mortality. Psychiatric medication intensity and frequency of
 
PRACTICE GUIDELINES
National Guideline Clearinghouse | New This Week
www.guidelines.gov -
NGC is the National Guideline Clearinghouse.
National Guideline Clearinghouse | Search Results
www.guidelines.gov -
NGC is the National Guideline Clearinghouse.
Microsoft Word
www.aacap.org -
This dramatic increase in attention-deficit/hyperactivity disorder, autism and depression has exasperated the already dire workforce crisis in child and adolescent psychiatry. ... When children and adolescents are unable to get timely access to



 
FROM PHYSICIANS PRACTICE
Five Steps to Improving Patient Access
Judy Capko,  May 21, 2013
Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
Growing HIPAA Threat – Ignore Windows XP at Your Own Peril
Marion K. Jenkins,  May 21, 2013
Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
Finding Physician Work-Life Balance in the Small Moments
Jennifer Frank, MD,  May 21, 2013
At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs.
Three Areas to Reduce Costs at Your Medical Practice
Greg Mertz,  May 19, 2013
By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
Dos and Don’ts for Starting a Physician Blog
Michael Woo-Ming, MD,  May 18, 2013
Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
 

 
 
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COUCH IN CRISIS

Parity Laws: Powerful Weapon—or Pipe Dream?
Psychiatric Times,  May 6, 2013
Grief and Depression: The Sages Knew the Difference
Psychiatric Times,  April 29, 2013
US Physicians and Burnout: Optimistic Psychiatrists Take Heart?
Psychiatric Times,  April 26, 2013
Lighting a Candle in Newtown
Psychiatric Times,  April 17, 2013
The Obama Plan—Spending Mental Health Money in All the Wrong Places
Psychiatric Times,  April 12, 2013