PSYCHIATRIC EMERGENCIES
- an urgent, serious disturbance of behavior,
affect, or thought that makes the patient
unable to cope with life situations and
interpersonal relationships.
- Patient may present at the ED:
● overactive or violent,
● underactive or depressed, or
● have suicidal behaviors.

Patients who are overactive
- Disturbed, uncooperative, and paranoid
behavior and those who feel anxious and
panicky may be prone to assaultive and
destructive impulses and abnormal social
behavior.
- Intense nervousness, depression, and
crying.
- Disturbed and noisy behavior may be
exacerbated or compounded by alcohol or
drug intoxication.
Intervention
- Introduce yourself by name.
- Tellthepatient,“I am here to help you.”
- Repeat the patient’s name from time to
time.
- Speak in one-thought sentences and be
consistent.
- Give the patient space and time to slow
down.
- Show interest in, listen to, and encourage
the patient to talk about personal thoughts
and feelings.
- Offer appropriate and honest explanations
Post-Traumatic Stress Disorder
- The development of characteristic
symptoms after a psychologically stressful
event
- (e.g., rape, combat, motor vehicle crash,
natural catastrophe, terrorist attack).
Post-Traumatic Stress Disorder Symptoms
- intrusive thoughts and dreams,
- phobic avoidance reaction (avoidance of
activities that arouse recollection of the
traumatic event),
- heightened vigilance,
- exaggerated startle reaction,
- generalized anxiety, and
- societal withdrawal.
Patients who are suicidal
- Attempted suicide is an act that stems from
depression
- e.g., loss of a loved one, loss of body
integrity or status, poor self-image
- Males are at greater risk
- Others at risk are
● older adults;
● young adults;
● people who are enduring unusual loss
or stress;
● those who are unemployed, divorced,
widowed, or living alone;
● those showing signs of significant
depression (e.g., weight loss, sleep
disturbances, somatic complaints,
suicidal preoccupation); and
● those with a history of a previous suicide
attempt, suicide in the family, or
psychiatric illness.
Signs and Symptoms of Potential Suicide
- Communication of suicidal intent
- History of a previous suicide attempt, with
risk being much greater in these cases
- Family history of suicide
- Loss of a parent at an early age
- Specific plan for suicide
- A means to carry out the plan
Emergency Management
Focuses:
- treating the consequences of the suicide
attempt (e.g., gunshot wound, drug
overdose) and preventing further self
injury.