Psychiatric Emergencies, Legal Issues, Gen. Medical Conditions

Front 1

Psychiatric emergencies involve what?

Back 1

Life threatening behavior and medico legal issues

Front 2

Psychiatric disorders include what?

Back 2

Substance abuse, schizophrenia, bipolar, manic, delirium, dementia, delusional disorder, and dissociative or fugue states.

Front 3

When dealing with violence associated with a clinical variable what are some of the examples?

Back 3

Stated plan to punch someone in the throat, Hx of acting-out personality disorders, punting orphans, and presence of dementia, delirium, ETOH-drug intoxication

Front 4

What information is needed when a call to the ER is made?

Back 4

Phone number, name of patient, address, danger?, has EMS responded

Front 5

What tips do you need to remember for a psychiatric interview?

Back 5

Time limited, focus on chief complaint, need collateral info from friends and fam, patient willing or unwilling?

Front 6

What main skills do you need when dealing with psychiatric interview?

Back 6

Straightforward, honest, calm, non threatening with SAFETY for yourself, patient, and self being your primary goal.

Front 7

What is the amount of info obtained in an interview based on?

Back 7

Manner, presentation, patience, listening skills, and observations

Front 8

If a patient is being violent how should you approach them?

Back 8

Slow and tactfully without appearing threatening. Use soft voices and maintain distance. DON'T ask what's wrong or why they're angry.

Front 9

How can you make sure that a violent psychiatric pt and the hospital can be safe?

Back 9

*Monitor the risk of violence and violent behaviors. *Document assessments with treatment plans. *Rid house of firearms * Treat underlying conditions. (REMEMBER- predicting violent behavior is difficult)

Front 10

How should you interview a potentially violent patient?

Back 10

1) never interview alone in an office or have door closed. 2) stay in sight of staff 3) leave a route for yourself-rapid escape 4) don't be in the way of patient and the door.

Front 11

What other practices should take place when interviewing a violent pt?

Back 11

* Don't be turning your back! * think about removing neckties, necklaces, or other stuff pt can grab or pull. * don't sit close to a paranoid pt. * don't challenge or confront pt * be alert of tension (impending violence)

Front 12

How do you know, when dealing with a psychotic patient, if it's an emergency?

Back 12

They're severely agitated (DTO), behavior is disorganized, violent outbursts, self destructive (DTS), unable to care for themselves, command hallucinations

Front 13

What are the principles of an Emergency Treatment plan for the psychotic patient?

Back 13

*Stabilize behavior *Institute specific interventions *Perform comprehensive psychiatric evalutaion *treat underlying psychiatric disorder/med. condition

Front 14

What are the medico legal implications?

Back 14

-Involuntary detention and treatment
-Involuntary administration of antipsychotic medications

Front 15

What is the emergency assessment of a combative/violent patient?

Back 15

-Harm to self or others. -past history of violence. -figure out why they're combative. -Determine stressors.- DELAY physical exam until pt's behavior is under control

Front 16

What is the emergency management for a combative/violent patient?

Back 16

*Set clear limits for patients threats and acts. *Verbal interventions are rarely effective. *Priority is SAFETY for staff, visitors, and yourself. * Search for concealed weapons. *Establish a rapport with patient

Front 17

What is the emergency assessment for the suicidal patient?

Back 17

*Take all suicide threats seriously * Establish rapport with patient. * Gather info of disorder, drug overdose, hopelessness, also gather info from fam and friends, other peeps

Front 18

How must you assess lethality with a suicidal patient?

Back 18

-patients suicidal thoughts/plans -history of suicide attempts -pt's view of future -suddent shifts of euphoria and suicidal -hoplessness -lack of support system

Front 19

What are the risk factors when dealing with a suicidal pt?

Back 19

history of suicide attempts, perceived hopelessness, psychiatric illness, gender, age, social isolation, low job satisfaction, chronic medical issues

Front 20

Who's at the greatest risk of sexual-physical abuse?

Back 20

Children, the elderly, and the disabled. Also people with cognitive impairment.

Front 21

What is the emergency assessment for sexual-physical abuse?

Back 21

Hiding the abuse, protecting abuser.
Don't blame victim for the abuse.

Front 22

How is psychopathology brought about?

Back 22

Emotional and physical trauma

Front 23

What is the emergency management for sexual- physical abuse?

Back 23

-protect patient from further abuse
-provide assurance and supportive therapy
-treat psychopathology

Front 24

What is Medico Legal for sexual-physical abuse?

Back 24

Some states have mandatory reporting requirements for health care personnel

Front 25

What are some other psychiatric emergencies?

Back 25

-Substance related emergencies
-refusal of life saving treatment
-emotional trauma

Front 26

What interventions could be used for psychiatric emergencies?

Back 26

*Providing a safe environment * protecting patient from self harm * protecting others from patient

Front 27

Who is technically legally competent?

Back 27

Person (over 18 years old) must understand risks, benefits, and outcomes of decisions

Front 28

How would you go about providing an interventions for a psychiatric pt

Back 28

-consultation to psychiatrist -psychotropic medication
-psychiatric hospitalization

Front 29

True Or False- A person can be hospitalized against their will if they are dangerous to self or others or unable to provide self-care.

Back 29

True

Front 30

True or False- Patients confined, whether voluntarily or involuntarily, retain none of their civil rights.

Back 30

False. They retain most of their civil rights (including the right to receive or refuse treatments)

Front 31

If a patient is determined to be incompetent are they allowed to refuse treatment?

Back 31

Nope. If they're suicidal you get to fix them up whether they like it or not!

Front 32

HIPPA stands for what? and what is it/

Back 32

Health Insurance Portability and Accountability Act. (1966) Physicians required to maintain confidentiality of their patients

Front 33

When are the only times a physicians aren't required to maintain confidentiality of a patient?

Back 33

When a patient is suspected of child/elder abuse. Risk for suicide. Danger to others. But you must ascertain the credibility of the threat/danger

Front 34

What is Tarasoff vs. the Regents of University of California I?

Back 34

Duty to Warn

Front 35

What is Tarasoff II?

Back 35

Duty to protect the intended victim

Front 36

What is the most common neurological disease?

Back 36

Epilepsy which makes up about 30-50% of psychiatric difficulties

Front 37

What are some medical conditions dealing with all this junk?

Back 37

Degenerative disorders- Parkinson's, Huntington's, Wilson Disease. Brain Tumors/Cysts. Head Trauma. Demyelinating disorders- MS, ALS, leukodystrophy, Infection-Encephalitis, Meningitis. Immune Disorders-Lupus. Endocrine Disorders-Thyroid, Adrenal. Metabolic-encephalopathy. Nutritional-Thiamine B1, B12. Toxins