Psychiatric Emergencies for the Adult Patient

Authors: Sarah Edwards, Phyllida Roe / Editors: Tim Dickinson, Adam Hickson, Liam Kevern / Reviewer: Mohamed Elwakil / Codes: A4, A5Published: 22/12/2017


Patients with mental health problems often present to the Emergency Department (ED). They will commonly be assessed and then treated, initially, by junior doctors. A recent survey shows that very few doctors have any further training in recognising and managing mental health problems once they leave medical school. Consequently they lack both the skills and confidence in recognising and managing these patients in the ED.

This module is intended to provide some guidance on commonly presenting problems in the acute environment. It will focus on the key elements of history in the context of making an initial assessment but will also provide information on immediate management. Assessments of risk of self-harm and harm to others, as well as potential risk to the doctor when working with a patient with mental health problems, will be included. This module will focus on adult patients only.

Learning Objectives:

  1. You will be more familiar with the components of the Mental State Examination
  2. You will be more familiar the sedation of psychotic or delirious patients
  3. You will be introduced to some of the considerations needed in paracetamol overdoses.
  4. You will be more familiar with management of patients presenting with delirium


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  20. RCEM Guidance: Paracetamol overdose: new guidance on the use of intravenous acetylcysteine

Related RCEMLearning resources:

Delirium in the Elderly

Acute delirium in the Elderly

Carbon Monoxide Poisoning

A brief guide to Section 136 for Emergency Departments

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