Anyone have any good advice for a solid resource? My program has the busiest pscyh ED in that state and I wanted to read up prior to starting.
Emergency Psychiatry
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She doesn't play the "suicide card" though.
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Hey OPD, just noticed that I just passed 1500 posts at the same time you passed 2500. They don't call you old for nothing. 
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Seriously! The "suicide card" was the only thing missing.
Thanks for sharing that, I laughed so hard...am working psych emergency clinic right now and saw a pt earlier this week who has a fixed delusion that he has neurosyphilis and whose chief complaint was "I need Xanax for my fibromyalgia which is caused by my neurosyphilis and all the parasites I picked up in my world travels, but we are still ruling out possible cancer. If I can't get Xanax can I have some Klonopin?"
It took a lot of self control to keep from prescribing him benzathine penicillin 2.4M units IM, but reconstituted w/ Haldol instead of the usual solution...
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Hey OPD, just noticed that I just passed 1500 posts at the same time you passed 2500. They don't call you old for nothing.
Oh yeah--look who's logged on and counting posts on a Friday night.
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https://www.emergencypsychiatry.org/
The above source may help you. I forgot the name of the journal, it may have been the AAEP's journal, but I occasionally got them in my residency mailbox. It had great articles on handling emergency psychiatry.
The above source may help you. I forgot the name of the journal, it may have been the AAEP's journal, but I occasionally got them in my residency mailbox. It had great articles on handling emergency psychiatry.
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I don't know the resource, but I wouldn't buy an $80 book. We have a very busy PES at our hospital, and it really is a lot of the same few problems repeated over and over. You'll learn how to do it well after only a short time there. Read up on managing agitation in the psychiatric emergency setting, suicide assessment (there is a great book on this by christopher shea) and possibly brief dbt-style interventions for managing personality disordered patents in the PES. If you are interested in specific references for articles I can post them when I return to work monday.
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Some potentially useful stuff at www.psychsign.org/education
Look under Intenships/Externships/Clerkships for
"NEW Psychiatry Quick Reference Cards for rotations (APA Version)"
and
"Psychiatry Clerkship Quick Reference Cards"
They may help you save time by avoiding looking up the same things many times.
Although some of the pharmacology is probably outdated, this probably has some good reading:
Pocket Handbook of Emergency Psychiatric Medicine by Harold I. Kaplan and Benjamin J., M.D. Sadock (Paperback - Jan 15, 1993)
AMAZON.com 6 new from $42.0013 used from $7.50
There are 2 questions you always have to ask yourself about every Psych Emergency Service (PES) patient:
"Does this patient absolutely need to be behind a locked door tonight in order to be treated?" [If not, do everything you can to use a less restrictive environment. Remember, psychosis does NOT mean an automatic admit.]
And just as important,
"Will I be able to justify my treatment decisions to the attending, the patient's family, and the jury?"
The second one requires experience for how YOUR institution handles questionable admits. You will have to feel it out over time. But in the beginning, try asking your attendings and seniors, "What are 1 or 2 differences in the presentation that would have caused you to change your decision and opt to admit (or not admit) that patient?" That will help them focus your attention on the key factors.
Look under Intenships/Externships/Clerkships for
"NEW Psychiatry Quick Reference Cards for rotations (APA Version)"
and
"Psychiatry Clerkship Quick Reference Cards"
They may help you save time by avoiding looking up the same things many times.
Although some of the pharmacology is probably outdated, this probably has some good reading:
Pocket Handbook of Emergency Psychiatric Medicine by Harold I. Kaplan and Benjamin J., M.D. Sadock (Paperback - Jan 15, 1993)
AMAZON.com 6 new from $42.0013 used from $7.50
There are 2 questions you always have to ask yourself about every Psych Emergency Service (PES) patient:
"Does this patient absolutely need to be behind a locked door tonight in order to be treated?" [If not, do everything you can to use a less restrictive environment. Remember, psychosis does NOT mean an automatic admit.]
And just as important,
"Will I be able to justify my treatment decisions to the attending, the patient's family, and the jury?"
The second one requires experience for how YOUR institution handles questionable admits. You will have to feel it out over time. But in the beginning, try asking your attendings and seniors, "What are 1 or 2 differences in the presentation that would have caused you to change your decision and opt to admit (or not admit) that patient?" That will help them focus your attention on the key factors.
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I don't know a number off hand but I wouldn't say too many. To give you an example, where I did residency, we had the only emergency psychiatry center in the bottom half of the state in NJ. NJ is a highly densely populated state. Yes there are emergency rooms that will ask psychiatrists to work in it. I'm not talking about that. I'm talking about a real psychiatric emergency center.
Cincinnati's University Hospital has one as well, and again, there isn't another psychiatry emergency center for quite a ways around here.
Other hospitals will improvise a psychiatry ER by having psychiatrists do consults in the ER.
In a week, I'm starting an audition rotation on an emergency psych (crisis intervention) service at a busy university hospital. It's recommended we bring a DSM pocketbook (which I have) and an emergency psych handbook (which I don't have). Any thoughts on the best emergency psych handbook, perhaps from this list...
http://www.amazon.com/s/ref=nb_sb_n...&field-keywords=emergency psychiatry handbook
Thanks so much!
http://www.amazon.com/s/ref=nb_sb_n...&field-keywords=emergency psychiatry handbook
Thanks so much!
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Looks great Doc Samson, thank you for the recommendation!
