Behavioral Emergencies for the Emergency Physician

Emergency physicians, in all practice settings, care for patients with both undifferentiated psycho-behavioral presentations and established psychiatric illness. This reference-based text goes beyond diagnostics, providing practical input from physicians experienced with adult emergency psychiatric patients. Physicians will increase their understanding and gain confidence working with these patients, even when specialized psychiatric back-up is lacking. Behavioral Emergencies for the Emergency Physician is comprehensive, covering the pre-hospital setting and advising on evidence-based practice; from collaborating with psychiatric colleagues to establishing a psychiatric service in your ED. Sedation, restraint and seclusion are outlined. Potential dilemmas when treating pregnant, geriatric or homeless patients with mental illness are discussed in detail, along with the more challenging behavioral diagnoses such as malingering, factitious and personality disorders. This go-to, comprehensive volume is invaluable for trainee and experienced emergency physicians, as well as psychiatrists, psychologists, psychiatric and emergency department nurses and other mental health workers.

Preface; Part I. General Considerations for Psychiatric Care in the Emergency Department: 1. The magnitude of the problem of psychiatric illness presenting in the emergency department; 2. Delivery models in emergency psychiatric care; Part II. Evaluation of the Psychiatric Patient: 3. The medical clearance process for psychiatric patients presenting acutely to the emergency department; 4. Advanced interviewing techniques for psychiatric patients in the emergency department; 5. Use of routine alcohol and drug testing for psychiatric patients in the emergency department; 6. Drug intoxication in psychiatric patients in the emergency department; 7. Drug withdrawal syndromes in psychiatric patients in the emergency department; Part III. Psychiatric Illnesses: 8. The patient with depression in the emergency department; 9. Assessment of the suicidal patient in the emergency department; 10. The patient with somatoform disorders in the emergency department; 11. The patient with anxiety disorders in the emergency department; 12. The patient with post traumatic stress disorder in the emergency department; 13. The patient with psychosis in the emergency department; 14. Personality disorders in the acute setting; 15. The patient with factitious disorders and malingering in the emergency department; 16. The patient with delirium and dementia in the emergency department; 17. The patient with excited delirium in the emergency department; 18. Medical illness in psychiatric patients in the emergency department; 19. Acute care of eating disorders; 20. Management of the emergency department patient with co-occurring substance abuse disorder; Part IV. Treatment of the Psychiatric Patient: 21. Use of verbal de-escalation techniques in the emergency department; 22. Use of agitation treatment in the emergency department; 23. Management of aggressive and violent behavior in the emergency department; 24. Restraint and seclusion techniques in the emergency department; 25. Use of psychiatric medications in the emergency department; 26. The patient with neuroleptic malignant syndrome in the emergency department; 27. Treatment of psychiatric illness in the emergency department; 28. Rapidly acting treatment in the emergency department; Part V. Special Populations: 29. Pediatric psychiatric disorders in the emergency department; 30. Geriatric psychiatric emergencies; 31. Disaster and terrorism emergency psychiatry; 32. Trauma and loss in the emergency setting; 33. Management of homeless and disadvantaged persons in the emergency department; 34. Management of neurobehavioral sequelae of traumatic brain injury in the emergency department; 35. Management of psychiatric illness in pregnancy in the emergency department; 36. Cultural concerns and issues in emergency psychiatry; 37. Rural emergency psychiatry; Part VI. Administration of Psychiatric Care: 38. Coordination of emergency department psychiatric care with psychiatry; 39. Integration with community resources; 40. The role of telepsychiatry; 41. Emergency medical services psychiatric issues; 42. Triage of psychiatric patients in the emergency department; 43. The Emergency Medical Treatment and Active Labor Act (EMTALA) and psychiatric patients in the emergency department; 44. Assessing capacity, involuntary assessment, and leaving against medical advice; 45. Best practices for the evaluation and treatment of patients with mental and substance use illness in the emergency department; 46. Improving emergency department process and flow; 47. Physical plant for emergency psychiatric care; 48. Legal issues in the care of psychiatric patients; 49. Law enforcement and emergency psychiatry; 50. Research in emergency psychiatry; Index.

Leslie S. Zun, MD is Chair, Department of Emergency Medicine, Mount Sinai Hospital, Chicago and Professor and Chair, Department of Emergency Medicine, Rosalind Franklin University of Medicine and Science/The Chicago Medical School, North Chicago, IL, USA.