Discussing First Aid Training Issues of Psychiatric Emergencies

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Tsopelas ◽  
F. Kapsali ◽  
S. Tsetsou ◽  
K. Kardaras ◽  
D. Oikonomou ◽  
...  
Keyword(s):  
Web Search ◽  
Treatment Guidelines ◽  
Psychiatric Treatment ◽  
Diagnostic Procedures ◽  
Psychiatric Emergencies ◽  
Medical Databases ◽  
Diagnosis By Exclusion ◽  
First Aid Training ◽  
Usual Clinical Practice ◽  
Medical Emergencies

Aims:Psychiatry is considered a specialty not having a lot to do with medical emergencies. Psychiatrists are being asked to contribute to medical treatment or diagnosis after the completion of diagnostic procedures by physicians, often concluded in a diagnosis by exclusion. Having said that, emergency psychiatric issues often arise in usual clinical practice.Methods:Thorough research of the main medical databases, and web search engines for relevant studies. We scrutinize them independently, before reaching consensus about appropriateness.Results:There are several books, articles and guidelines that go beyond the psychiatric emergencies of mentally ill patients, aiming to provide guidelines for the providers of emergency treatment in settings that access to psychiatric treatment is limited due to obstacle of time or distance.Conclusions:Although general in concept and not particularly concerned with the accuracy of psychiatric diagnosis and the description of symptoms and signs of psychopathology, there are general guidelines well described that a qualified nurse, social worker or an ambulance worker could apply. We have an obligation to disseminate knowledge about dealing with psychiatric emergencies especially to health services at remote areas. Publication of treatment guidelines that are easy to apply, could be the next step in recognition, early intervention and appropriate referral in challenging psychiatric situations at the members states of European Union.

Long-term survival of the nasal NK/T cell lymphoma

2008 ◽  
Vol 149 (17) ◽  
pp. 801-805
Author(s):  
Péter Rajnics ◽  
László Krenács ◽  
András Kenéz ◽  
Zoltán Járay ◽  
Enikő Bagdi ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Guidelines ◽  
Cell Lymphoma ◽  
Treatment Options ◽  
Diagnostic Procedures ◽  
T Cell Lymphoma ◽  
Term Survival ◽  
Barr Virus ◽  
Significant Difference ◽  
Nk T Cell

The nasal NK/T cell lymphoma is a rare, extranodal non-Hodgkin lymphoma in western civilizations, which has poor prognosis. The Epstein–Barr virus can be detected in tumor cells in nearly all cases. There are no definite treatment guidelines in our days. There is no significant difference in survival between radiotherapy and chemotherapy according to Asian studies. In this case study we show our diagnostic procedures, our treatment options and we present the summary of this illness based on the data found in the literature.

Nicotine as therapeutic agent in treatment of mood disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S552-S552
Author(s):  
C. Tsopelas ◽  
N. Petros ◽  
D. Maria ◽  
P. Dimitris ◽  
G.G. Angelica ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Acetylcholine Receptors ◽  
Web Search ◽  
Therapeutic Agent ◽  
Negative Attitude ◽  
Medical Databases ◽  
Positive Effects ◽  
Complex Interactions ◽  
Competing Interest ◽  
The Brain

IntroductionThe plant that has as active ingredient nicotine was chewed or smoked for many years from American natives, for its therapeutic properties. Nowadays after the extensive negative attitude towards smoking, the main provider of nicotine, researchers are now pointing out the therapeutic possibilities of nicotine in mood disorders, as a substance that is acting in the acetylcholine receptors in the brain.AimsIn this review we are trying to explore the possibilities of nicotine use as a therapeutic agent.MethodsWe did a detailed research of the main medical databases, and web search engines for relevant studies. We scrutinize them independently, before reaching consensus about appropriateness for inclusion in the study.ResultsDiadermal administration of nicotine has a positive effect in depressive disorder in 3–8 days, an effect that in one study was reversed after cessation of nicotine. Patients with depression and/or healthy subjects show improvement of attention and working memory after diadermal use of nicotine. Research is not conclusive in the sustainability of these positive affects as other researchers emphasize their short effect in mood.ConclusionNicotine presents as part of novel and promising therapeutic agents with complex interactions with other neurotransmitters in the brain. Before condemning nicotine along with smoking we should acknowledge the potential use of nicotine as a therapeutic compound since research shows that some of these positive effects appear not only to smokers after abstinence but also to non-smokers.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Adherence to guidelines for treatment of depression in in-patients

2005 ◽  
Vol 187 (5) ◽  
pp. 462-469 ◽  
Author(s):  
Frank Schneider ◽  
Martin Härter ◽  
Silke Brand ◽  
Petra Sitta ◽  
Ralph Menke ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Treatment Guidelines ◽  
Psychiatric Treatment ◽  
Psychiatric Hospitals ◽  
High Standard ◽  
Quality Data ◽  
Management Tools ◽  
Interpersonal Therapy ◽  
Adherence To Guidelines ◽  
Treatment Of Depression

BackgroundAdherence to treatment guidelines enhances treatment outcome. However, in clinical practice many patients with depression do not receive appropriate treatment.AimsTo evaluate the treatment of depression in in-patients of German psychiatric hospitals with respect to treatment outcome and adherence to guidelines.MethodWe recruited 1202 in-patients with depression from ten different hospitals. Quality data concerning treatment were collected at admission, during the treatment course and at discharge.ResultsThe level of depression was significantly decreased and most patients were satisfied with treatment. Many aspects of the treatment routine adhered to guideline recommendations. Adherence to guidelines could be improved with respect to adjustment of antidepressant dosage, reduction of benzodiazepine prescription, enhanced use of electroconvulsive therapy and wider use of interpersonal therapy.ConclusionsThe study reveals a high standard of psychiatric treatment of in-patients with depression. Nevertheless there is still room for improvement. Differences between hospitals in adherence to guidelines indicates the need for individual application of quality management tools.

Psychopharmacology in Psychiatric Emergencies

1981 ◽  
Vol 10 (3) ◽  
pp. 189-204 ◽  
Author(s):  
Irl Extein
Keyword(s):  
Psychiatric Treatment ◽  
Emergency Setting ◽  
Antipsychotic Medications ◽  
Psychiatric Emergencies ◽  
Medical Disorders ◽  
Steady State Kinetics ◽  
Sedative Hypnotics ◽  
Time Required ◽  
Effective Use ◽  
Severe Anxiety

Pharmacotherapy is crucial to the emergency psychiatric treatment of patients who are out of control in a variety of psychiatric and medical disorders. The time required for the more definitive pharmacological treatment of the major psychiatric syndromes is such that they can at best be only started in the emergency setting. The emergency treatment of patients who are severely agitated, violent, or psychotic is based on the IM administration of antipsychotic medications, such as haloperidol. In conjunction with psychological support this can provide effective, safe, and humane treatment. Sedative-hypnotics, such as diazepam, can be helpful for less severe anxiety states. This article focused on clinical and pharmacokinetic principles of the use of these medications, the understanding of which can help maximize their effective use in emergencies. Topics which are emphasized include sedative, antipsychotic and disinhibiting effects, side effects, absorption after oral and IM administration, and the concepts of steady-state kinetics and the “loading dose.”

Oxford Handbook of Acute Medicine

2019 ◽  
Author(s):  
Punit Ramrakha ◽  
Kevin Moore ◽  
Amir Sam
Keyword(s):  
Clinical Medicine ◽  
Treatment Guidelines ◽  
Acute Medicine ◽  
Psychiatric Emergencies ◽  
Neurological Emergencies ◽  
Immunodeficiency Virus ◽  
Recent Treatment ◽  
Drug Overdoses ◽  
Cardiac Emergencies ◽  
Respiratory Emergencies

This title is a practical and comprehensive guide to the management of the acutely ill patient. It is a single source to the most up-to-date therapies and protocols. It presents the most recent treatment guidelines and evidence-based content that is up-to-date with the recent advances in clinical medicine. Topics covered include cardiac emergencies, respiratory emergencies, gastroenterological emergencies, renal emergencies, shock, neurological emergencies, infectious diseases, emergencies in human immunodeficiency virus, diabetes and endocrine emergencies, haematological emergencies, rheumatological emergencies, dermatological emergencies, psychiatric emergencies, drug overdoses, and practical procedures in acute medicine.

scholarly journals Clinical effectiveness of treatments for anorexia nervosa in adolescents

2007 ◽  
Vol 191 (5) ◽  
pp. 427-435 ◽  
Author(s):  
Simon G. Gowers ◽  
Andrew Clark ◽  
Chris Roberts ◽  
Alison Griffiths ◽  
Vanessa Edwards ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Health Service ◽  
Treatment Guidelines ◽  
Psychiatric Treatment ◽  
Controlled Trial ◽  
Clinical Effectiveness ◽  
Patient Treatment ◽  
Intention To Treat ◽  
Poor Outcomes ◽  
Randomised Controlled

BackgroundTreatment guidelines identify few adequately powered trials to guide recommendations for anorexia nervosa.AimsTo evaluate the effectiveness of three readily available National Health Service treatments for adolescents (aged 12–18 years) with anorexia nervosa.MethodMulticentre randomised controlled trial of 167 young people comparing in-patient, specialist out-patient and general child and adolescent mental health service (CAMHS) treatment.ResultsEach group made considerable progress at 1 year, with further improvement by 2 years. Full recovery rates were poor (33% at 2 years, 27% still with anorexia nervosa). Adherence to in-patient treatment was only 50%. Neither in-patient nor specialist out-patient therapy demonstrated advantages over general CAMHS treatment by intention to treat, although some CAMHS out-patients were subsequently admitted on clinical grounds. In-patient treatment (randomised or after out-patient transfer) predicted poor outcomes.ConclusionsFirst-line in-patient psychiatric treatment does not provide advantages over out-patient management. Out-patient treatment failures do very poorly on transfer to in-patient facilities.

scholarly journals Awareness, attitudes and practices of first aid among school teachers in Mangalore, south India

2015 ◽  
Vol 7 (4) ◽  
pp. 274 ◽  
Author(s):  
Nitin Joseph ◽  
Thanneermalai Narayanan ◽  
Saifuddin bin Zakaria ◽  
Abhishek Venugopal Nair ◽  
Lavina Belayutham ◽  
...  
Keyword(s):  
Health Knowledge ◽  
First Aid ◽  
Medical Attention ◽  
School Teachers ◽  
Attitudes And Practices ◽  
First Aid Training ◽  
Medical Emergencies ◽  
Self Administered Questionnaire ◽  
Health Knowledge Attitudes Practice ◽  
Competency Level

INTRODUCTION: Circumstances requiring medical attention are common at schools. Teachers are often the first individuals to witness and handle situations requiring first aid and medical emergencies. AIM: To determine awareness, attitudes and practices of school teachers and the facilities available at schools with respect to administration of first aid. METHODS: Data were obtained from 146 teachers in nine schools in Mangalore, India, using a self-administered questionnaire. The schools were also inspected for first aid equipment and facilities. RESULTS: Only 69 (47%) teachers had received first aid training previously. Poor and moderate knowledge of first aid was observed among 19 (13%) and 127 (87%) teachers, respectively. Only eight teachers knew the correct procedure for cardiopulmonary resuscitation. Most teachers 96 (66%) were willing to administer first aid if provided with the required training. A total of 74 teachers reported having practised first aid in response to a situation arising at their school. Wounds (36%) and syncopal attack (23%) were among the commonly encountered situations requiring first aid management at schools. Teachers? confidence level in administering first aid was significantly associated with prior training in first aid (p=0.001). First aid kits were available in only five of the nine schools surveyed. DISCUSSION: The current competency level among teachers in Mangalore to administer first aid is inadequate. Measures need to be taken at schools to ensure initiation of first aid training followed by periodic training for teachers in first aid. KEYWORDS: First aid; health knowledge, attitudes, practice; India; schools

scholarly journals Epidemiology, Diagnostics, and Treatment of Narcolepsy in Germany: The DORMIO Study

2021 ◽  
Vol 18 (2) ◽  
pp. 88-99
Author(s):  
Sabrina Müller ◽  
Alina Brandes ◽  
Julia Knierim ◽  
Milan Novakovic ◽  
Thomas Wilke ◽  
...  
Keyword(s):  
Matched Control ◽  
Healthcare Resource ◽  
Treatment Guidelines ◽  
Diagnostic Procedures ◽  
Healthcare Resource Utilization ◽  
Control Group ◽  
German Population ◽  
High Prevalence ◽  
Direct Healthcare Costs ◽  
The Mean

Objectives: This study aimed to investigate the prevalence, incidence, and real-world diagnostic and treatment patterns, healthcare resource utilization (HCRU), and associated costs of narcolepsy in Germany. Methods: This study was based on German claims data (2013–2018). Any patient with at least two outpatient specialist diagnoses and/or one inpatient diagnosis of narcolepsy was eligible for inclusion. Three cohorts were specified: 1) narcolepsy-prevalent patients alive on July 1, 2017; 2) narcolepsy-incident patients; and 3) newly treated patients. Descriptive analyses of the outcome measures were conducted. Results: We identified 133 prevalent narcolepsy patients (mean age: 46.2 years, 36.3% female), 71 incident patients, and 41 treatment starters. The prevalence of narcolepsy was 3.1–9.1 per 100,000 persons within the German population; the cumulative incidence between July 1, 2017, and June 30, 2018, was 0.83/100,000 persons. Among the incident patients, 62.0% underwent at least one predefined diagnostic procedure. Modafinil was the most prescribed medication for the treatment starters (46.3%) and prevalent patients (24.1%), but 59.4% of the prevalent patients did not receive any narcolepsy-specific pharmacological treatment. Prevalent patients with narcolepsy consulted physicians significantly more often than a healthy matched control group and experienced more all-cause hospitalizations. The mean total direct healthcare costs were higher for narcolepsy patients by €2,429 per patient-year. Conclusions: Not all narcolepsy patients undergo appropriate diagnostic procedures or narcolepsy-specific medications, as indicated by the treatment guidelines. More emphasis on the optimization of the management of this disease is needed, given its high prevalence and associated economic burden.

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