Down the Rabbit Hole: Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies

Veronica Tucci; Kaylin Siever; Anu Matorin; Nidal Moukaddam

doi:10.1016/j.emc.2015.07.002

Down the Rabbit Hole: Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies

Emerg Med Clin North Am. 2015 Nov;33(4):721-37. doi: 10.1016/j.emc.2015.07.002. Epub 2015 Sep 5.

Authors

Veronica Tucci¹, Kaylin Siever², Anu Matorin³, Nidal Moukaddam³

Affiliations

¹ Section of Emergency Medicine, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030, USA. Electronic address: Tucci@bcm.edu.
² Section of Emergency Medicine, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030, USA.
³ Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1502 Taub Loop, NPC Building 2nd Floor, Houston, TX 77030, USA.

PMID: 26493519
DOI: 10.1016/j.emc.2015.07.002

Abstract

Patients presenting with behavior or psychiatric complaints may have an underlying medical disorder causing or worsening their symptoms. Misdiagnosing a medical illness as psychiatric can lead to increased morbidity and mortality. A thorough history and physical examination, including mental status, are important to identify these causes and guide further testing. Laboratory and ancillary testing should be guided by what is indicated based on clinical assessment. Certain patient populations and signs and symptoms have a higher association with organic causes of behavioral complaints. Many medical problems can present with or exacerbate psychiatric symptoms, and a thorough medical assessment is imperative.

Keywords: Medical clearance; Medical screening; Medical stability; Psychiatric and behavioral emergencies.

Publication types

Review

MeSH terms

Emergencies*
Emergency Service, Hospital / organization & administration*
Humans
Mental Disorders / diagnosis*
Triage / organization & administration*