Psychiatry in Emergency Medicine

[medislife15370]

Advertisement - Members don't see this ad

I am very interested in the medical aspect in emergency medicine. The fact that you see a little of everything interests me! However, I am also interested in psychiatry. My question is, how much psychiatry do you see in the emergency room as a regular EM Physician?

 

[sliceofbread136]

You'll see quite a bit

 

[LizzyM]

I am very interested in the medical aspect in emergency medicine. The fact that you see a little of everything interests me! However, I am also interested in psychiatry. My question is, how much psychiatry do you see in the emergency room as a regular EM Physician?

You will see it. But aside from calling a psych consult and/or admitting to psych, there will be little you can do about it. (you can deal with the physical consequences related to suicide attempts and other deliberate harm to self, homelessness and other events leading to exposure to the elements, drug and alcohol overdoses, etc but not the underlying psychiatric conditions). The ED has no capacity to follow-up and most of psychiatry is being with patients for the long haul.

 

[kopftonmd]

You could also be a psychiatrist who works (either primarily or on a locums basis) in the ER; many departments have dedicated psych sections. If you look in the Psych and EM threads, you can likely find many more specifics.

 

[Stagg737]

You'll see a lot, as any suicide attempt or patient that makes statements of suicidal ideation will typically come through the ER before being going over to psych unless they've already got a psychiatrist/therapist who refers them straight to inpatient. The psychiatric hospital I rotated through was called about a patient being referred from the ER almost every day, so it's very common.

That being said, LizzyM is right about treatment. The ED is basically just there to stabilize the patient and hold them if they're suicidal but don't want to be committed. There are a few other cases where the ED steps in and treats psych issues (mostly related to substance abuse), but for the most part the EM guys don't treat psych patients.

If you're interested in seeing a little bit of everything and actually treating a little bit of everything, you're better off pursuing family med as the ED guys mostly just triage and stabilize people then send them on their way (though sometimes they do act as FM's if the patients are uninsured or idiots). Yes, they get exposure to other fields, but the lack of continuity of care is a big turn off from EM for a lot of people. In FM, you see everything (other than those brought in via ambulance), treat everything, and see everyone in follow-up. The big difference, other than the obvious trauma aspect of EM, is that FM docs will refer patients to specialists when they feel the patient's condition is outside their scope or think the patient would do better seeing a specialist, EM docs will end up referring everyone that actually needs to be seeing a physician.

 

[RunawayGrape]

.

 

[MareNostrummm]

Extremely common, I scribe in several EDs and psychotic episodes from schizophrenia, manic bipolar episodes, panic attacks, depressive suicide attempts, etc are a daily occurrence. You will also see a lot of methamphetamine, heroin, and PCP abuse. Even seemingly mentally healthy people will have histories of depression and anxiety.