scholarly journals A Retrospective Review of Antipsychotic Medications Administered to Psychiatric Patients in a Tertiary Care Pediatric Emergency Department

2019 ◽  
Vol 24 (3) ◽  
pp. 234-237
Author(s):  
Frances Rudolf ◽  
Kathryn Hollenbach ◽  
Keri L. Carstairs ◽  
Shaun D. Carstairs
Keyword(s):  
Length Of Stay ◽  
Antipsychotic Medication ◽  
Pediatric Patients ◽  
Psychiatric Patients ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Antipsychotic Medications ◽  
Intramuscular Dose ◽  
Oral Medications ◽  
Chief Complaints

OBJECTIVES An increasing number of pediatric patients with psychiatric chief complaints present to emergency departments (EDs) nationwide. Many of these patients require treatment with antipsychotic medications to treat agitation. We sought to examine the use of antipsychotic medications in pediatric patients presenting to a tertiary care pediatric ED. METHODS We performed a retrospective electronic medical record review of patients presenting to a tertiary care pediatric hospital from January 2009 through February 2016 with a psychiatric chief complaint who received an antipsychotic medication in the ED. RESULTS A total of 229 patients were identified, 54.1% of whom were male. Mean age was 14.4 ± 2.6 years. Commonly administered medications included olanzapine (51.1%), aripiprazole (26.6%), haloperidol (24.0%), and risperidone (11.8%). Eighty-seven patients (38.0%) were given at least 1 intravenous or intramuscular dose of antipsychotic medication. A total of 113 patients (49.3%) received only 1 antipsychotic medication, 65 (28.4%) received 2, 30 (13.1%) received 3, and 21 (9.2%) received 4 or more antipsychotics. Median length of stay (minutes) increased significantly with increasing number of medications administered (p < 0.001). Length of stay was significantly shorter in patients given only oral medications (675.6 minutes, IQR 418–1194) compared to those given at least one intramuscular or intravenous dose (951 minutes, IQR 454–1652) (p = 0.014). CONCLUSIONS In this retrospective series, the majority of patients were treated with newer oral antipsychotics. Administration of multiple medications was associated with a significantly longer length of stay in the ED, as was parenteral administration of antipsychotics.

scholarly journals Hyponatremia among Psychiatric Patients Using Antipsychotic Medication in a Tertiary Hospital in South-South, Nigeria

2018 ◽  
Vol 04 ◽  
pp. 28
Author(s):  
Emmanuel O. Olose ◽  
Donald C. Chukwujekwu ◽  
Monday N. Igwe ◽  
Miriam C. Aguocha ◽  
Cecilia O. Busari ◽  
...  
Keyword(s):  
Antipsychotic Medication ◽  
Serum Sodium ◽  
Psychiatric Patients ◽  
Venous Blood ◽  
Tertiary Hospital ◽  
Typical Antipsychotic ◽  
Inclusion Criteria ◽  
Interview Schedule ◽  
Antipsychotic Medications ◽  
Atypical Antipsychotic Medications

The aim of this study was to determine the prevalence of hyponatremia among psychiatric patients taking antipsychotics, to determine the correlation between serum sodium levels and dosage of medications as well as to determine the association between class of antipsychotic medication and serum sodium levels among patients taking antipsychotic medications. This is a longitudinal study. From 92 consenting antipsychotic na�ve patients who met the inclusion criteria, sociodermographic interview schedule was administered. Thereafter, a single venous blood sample was obtained for serum electrolyte analysis and repeated after 6 weeks. Prevalence of hyponatremia was 19.4%, there was a correlation between hyponatremia and dose of antipsychotic in chlorpromazine equivalent (r = −0.354; p = 0.01), and there is an association between typical antipsychotic use and hyponatremia. The use of both typical and atypical antipsychotic medications can lead to hyponatremia. This is in keeping with previous reports.

scholarly journals Unfavourable outcome for children leaving the emergency department without being seen by a physician

CJEM ◽  
2013 ◽  
Vol 15 (05) ◽  
pp. 289-299 ◽  
Author(s):  
Jocelyn Gravel ◽  
Serge Gouin ◽  
Benoit Carrière ◽  
Nathalie Gaucher ◽  
Benoit Bailey
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Primary Outcome ◽  
Tertiary Care ◽  
Invasive Procedure ◽  
Pediatric Emergency ◽  
Secondary Outcome ◽  
Unfavourable Outcome ◽  
Left Without Being Seen ◽  
Chief Complaints

ABSTRACTObjective:To assess the prevalence of an unfavourable outcome among children leaving without being seen by a physician in the emergency department (ED).Method:This was a prospective cohort study conducted over a complete year in a pediatric tertiary care ED. A random sample of all children younger than 19 years of age who left without being seen by a physician was contacted by phone 4 to 6 days following the ED visit. The primary outcome was the occurrence of an unfavourable outcome prospectively defined using a Delphi method among 15 pediatric emergency physicians. An unfavourable outcome was defined as hospitalization, the need for an invasive procedure (intravenous or intramuscular medication, fracture reduction, bone casting, or surgical intervention), suicide attempt, or death in the 72 hours following leaving without being seen by a physician. As a secondary outcome, multiple potential predictors were evaluated. The first analysis evaluated the proportion of unfavourable outcomes among children who left without being seen by a physician. Then logistic regression identified predictors of unfavourable outcomes.Results:During the study period, 61,909 children presented to the ED, 7,592 (12%) left without being seen by a physician, and 1,579 were recruited. Thirty-eight (2.4%; 95% CI 1.7–3.2) patients fulfilled the criteria for an unfavourable outcome. On multiple logistic regression, chief complaints related to trauma and absence of nurse counseling had higher risks of unfavourable outcome.Conclusions:Approximately 2% of children who left without being seen by a physician at a tertiary care pediatric ED had an unfavourable outcome.

CIScoSI Study [Children Immunization Status and cases of Systemic Illness]

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Infectious Diseases ◽  
East Asia ◽  
Pediatric Patients ◽  
Severe Disease ◽  
Tertiary Care ◽  
Immunization Coverage ◽  
South East Asia ◽  
Immunization Status ◽  
Tertiary Care Hospitals ◽  
Total Coverage

To determine the immunization status of pediatric patients under age of 5 years visiting pediatric department of tertiary care hospitals in South East Asia. The aim of this study was to appreciate the awareness and implementation of vaccination in pediatric patients who came into pediatric outpatient Department with presenting complain other than routine vaccination. we can also know the count of patients who do not complete their vaccination after birth. we can differentiate between vaccinated and unvaccinated patients and incidence of severe disease in both groups. Immunization is a protective process which makes a person resistant to the harmful diseases prevailing in the community, typically by vaccine administration either orally or intravenously. It is proven for controlling and eliminating many threatening diseases from the community. WHO report that licensed vaccines are available for the prevention of many infectious diseases. After the implementation of effective immunization the rate of many infectious diseases have declined in many countries of the world. South-East Asia is far behind in the immunization coverage. An estimated total coverage is 56%-88% for a fully immunized child, which is variable between countries. Also the coverage is highest for BCG and lowest for Polio.

Ayurvedic understanding of Central Pontine Myelinolysis - A Case Report

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Anoop AS ◽  
Lakshmiprasad L. Jadhav ◽  
Sruthy Nair ◽  
Rohan Mohandas
Keyword(s):  
Serum Sodium Level ◽  
Central Pontine Myelinolysis ◽  
Chronic Alcoholism ◽  
Serum Electrolyte ◽  
Oral Medications ◽  
Shoulder Joints ◽  
Pontine Myelinolysis ◽  
Chief Complaints ◽  
Hyponatremic Encephalopathy ◽  
Central Pontine

A 56 year old male patient was admitted to S.D.M Ayurveda Hospital, Hassan, Karnataka with the confirmed diagnosis of Central Pontine Myelinolysis (CPM) on 11/12/17. The chief complaints were weakness of both hands and legs, stiffness in both hands and legs, pain in both shoulder joints, slurred speech, difficulty in walking with gait changes. H/O chronic alcoholism. MRI brain showed pontine and basal ganglia diffusion restriction - Acute Pontine Myelinolysis. The serum electrolyte showed serum sodium level as 128 mmol/litre. This disease can be understood as Samana Avruta Vyana in hyponatremic encephalopathy stage and the stage of myelinolysis can be understood as Sarvanga Vata with Kapha Avruta Udana and Vyana. After clinical evaluation, Avarana Chikitsa was started followed by Kevala Vatika Chikitsa and significant improvement was seen. Significant result was observed in subjective and objective parameters after the treatment. The patient was discharged with oral medications for 1 month.

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