Psychiatric Emergencies for Physicians: Clinical Management and Approach to Distinguishing Pheochromocytoma From Psychiatric and Thyrotoxic Diseases in the Emergency Department

Most medical devices are routinely recognized on radiological images and described as normal findings in the radiological report, but sometimes they can cause patient access to the emergency department. Multiple possible complications have been described and most of them require prompt recognition by radiologists for proper clinical management. This commentary proposes a systematic approach to radiological reporting of the most common emergent complications related to medical devices with the intent to avoid the omission of important findings in the final radiological report.

Download Full-text

Treating Psychiatric Emergencies in Incarcerated Minors in the Emergency Department

Pediatric Emergency Care ◽

10.1097/pec.0000000000000147 ◽

2014 ◽

Vol 30 (6) ◽

pp. 403-408 ◽

Cited By ~ 2

Author(s):

David Brian Wood ◽

Joy Joelle Donofrio ◽

Genevieve Santillanes ◽

Chun Nok Lam ◽

Ilene Claudius

Keyword(s):

Emergency Department ◽

Psychiatric Emergencies ◽

Incarcerated Minors

Download Full-text

Renal colic, where is it headed? An observational study

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2016.1.7 ◽

2016 ◽

Vol 88 (1) ◽

pp. 7 ◽

Cited By ~ 2

Author(s):

Paolo Beltrami ◽

Andrea Guttilla ◽

Lorenzo Ruggera ◽

Patrizia Bernich ◽

Filiberto Zattoni

Keyword(s):

Emergency Department ◽

Urinary Tract ◽

Observational Study ◽

Clinical Management ◽

Renal Colic ◽

Ureteral Stone ◽

Ureteral Calculi ◽

Ureteral Calculus ◽

Spontaneous Expulsion ◽

Pain Symptoms

Aim: In the last thirty years, the treatment for renal and ureteral calculi has undergone profound variations. The objective of this study has been to evaluate the existence of parameters which can affect the spontaneous expulsion of a symptomatic ureteral stone in a reasonably brief period of time and to identify whether certain parameters such as sex, age, the location and dimension of the stone, the presence of dilation in the urinary tract together with the administered therapy, can be used for a correct clinical management of the patient. Methods: In a period of 9 months, 486 cases of renal colic were registered at emergency department. Results: The cases of renal colic due to ureteral calculus were 188 (38.7%). The patients’ charts, complete of all data and therefore, valid for this research, resulted to be 120 (64%). In the presence of a symptomatic ureteral stone, the correct approach must first of all, focalize on the dimension of the calculus itself; less importance instead, is given to the location, as reported in other studies, the presence of hydroureteronephrosis, sex and the side. Conclusion: In the cases when the pain symptoms cannot be solved by means of the administration of analgesics, it is then reasonable to take into consideration an immediate endourological treatment. If the pain symptoms are promptly solved, an attentive wait of 4 weeks should be considered reasonable in order to allow spontaneous expulsion of the calculus.

Download Full-text

How do blood cultures sent from a paediatric accident and emergency department influence subsequent clinical management?

Emergency Medicine Journal ◽

10.1136/emj.20.4.347 ◽

2003 ◽

Vol 20 (4) ◽

pp. 347-348 ◽

Cited By ~ 5

Author(s):

P Leonard

Keyword(s):

Emergency Department ◽

Clinical Management ◽

Blood Cultures ◽

Accident And Emergency ◽

Accident And Emergency Department

Download Full-text

Audit of psychiatric emergencies in the A & E department of an urban general hospital

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700013045 ◽

1993 ◽

Vol 10 (2) ◽

pp. 124-127 ◽

Cited By ~ 1

Author(s):

Marcus Webb ◽

Douglas Webb ◽

Glenn Webb

Keyword(s):

Patient Care ◽

General Hospital ◽

Social Services ◽

Clinical Management ◽

Psychiatric Service ◽

Management Strategies ◽

Special Focus ◽

Psychiatric Emergencies ◽

Retrospective Audit ◽

Careful Assessment

AbstractObjectives: To ascertain the frequency and nature of emergencies referred to psychiatrists at the A & E Department of an urban teaching general hospital. Deliberate self-harm and other forms of violence were to be special foci of the study, as was substance abuse, particularly alcohol abuse. Clinical management strategies used by psychiatric emergency staff were also to be assessed. Method: A retrospective audit was made of all of the reports of emergencies written by psychiatric trainees (who were first on call to the A & E) during a six-month period (January-June, 1991). The reports were analysed according to demographic characteristics, main clinical problem, presence or absence of each special focus problem, and also clinical management strategies. Main outcome measures were recorded as percentages of relevant groupings. Mean and median ages were reported as indicated. Results: The 550 emergency psychiatric reports represented 2.2% of A & E attendances. Fifty-two percent were male and 70% were between 15 and 44 years of age. Forty-eight percent resided outside the psychiatric catchment area of St. James's Hospital. Forty-six percent of all psychiatric emergencies required careful assessment of suicidal potential; twenty percent were admitted to inpatient care, 53% were referred to out-patient or day-patient care, 7% to their general practitioner and just 3% to social services. Conclusions: 1. Emergency assessment at the A & E provides a considerable workload for the psychiatric service of an urban general hospital. 2. Careful assessment of suicidal potential still represents an important part of this emergency work. 3. Only 1 in 5 patients were referred on to in-patient care. Undue pressure should not be placed on psychiatric trainees to manage potentially suicidal patients outside hospital. 4. Few referrals were made by psychiatric trainees to general practitioners or to the social services, suggesting that more formal consultant supervision of trainees in this emergency work is warranted.

Download Full-text