Psychiatric Complaints

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 23 December 2018

⏱️ 9 minutes

🔗️ Recording | iTunes | RSS

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Summary

The Two Objectives During Every Psychiatric-Type Complaint Medical Clearance Psychiatric Risk Assessment Medical Clearance Required by EMTALA to perform a “screening exam” regardless of complaint Most psychiatric facilities have poor diagnostic/treatment capabilities for non-psychiatric conditions and will want patient to be “medically cleared” Sometimes they will require specific tests to be performed, blood pressure to […]

Transcript

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0:00.0	Hello, med students. My name is Zach Olson, and thank you for downloading this week's
0:07.3	episode of the EM Clerkship Podcast. Today, we will be covering one of the most requested
0:16.3	topics that you all have been requesting recently, psych psychiatry. It's been long overdue. There is a large group of patients that you will have been requesting recently, psych, psychiatry, it's been long overdue.
0:22.0	There is a large group of patients that you will see on your rotation that are there for
0:26.3	psychiatric screening, right?
0:28.4	Like suicidal ideation, psychosis, anxiety.
0:32.0	With all of these situations, ED doctors follow the same kind of general formula that we're going to go through
0:38.9	today with a little bit of variation. But you will encounter this frequently. This is the approach to
0:45.7	psych. So let's do it. I want to keep the concepts today really nice and basic. There are two big
0:53.6	objectives with these patients when they're in the emergency department.
0:57.6	Two objectives that we're going to cover today. You have two jobs as the emergency medicine
1:01.7	doctor on these cases. The medical clearance side of things and then the psychiatric risk
1:08.8	assessment. Medical clearance, psychiatric risk screening.
1:14.4	Equal parts to what you're trying to do. And it's actually pretty quite straightforward,
1:19.3	actually. You have a patient, and the chief complaint is suicidal ideation or whatever,
1:25.3	medical clearance with all of these cases, all psychiatric complaints,
1:30.2	you need to do a medical screening exam. Medical clearance essentially for two reasons.
1:36.5	One, let's say that this patient truly has severe suicidal ideation or a severe psychosis or
1:43.5	something. They need inpatient psychiatry,
1:47.1	probably. And apparently, basically, you're the last doctor that has the chance to address
1:52.6	non-psychiatric complaints before they go to inpatient psych. Before psychiatric facilities accept
1:59.4	these patients, they want a doctor, they want you to sign
	...

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