Adult Psychiatric Patient in the Emergency Department
Publication Date: January 1, 2017
Last Updated: March 14, 2022
Recommendations
Do not routinely order laboratory testing on patients with acute psychiatric symptoms. Use medical history, previous psychiatric diagnoses, and physician examination to guide testing. (C)
334012
Use individual assessment of risk factors to guide brain imaging in the emergency department for patients with new-onset psychosis without focal neurologic deficit. (Consensus recommendation) (C)
334012
In patients presenting to the emergency department with suicidal ideation, physicians should not use currently available risk-assessment tools in isolation to identify low-risk patients who are safe for discharge. The best approach to determine risk is an appropriate psychiatric assessment and good clinical judgment, taking patient, family, and community factors into account. (C)
334012
Ketamine is one option for immediate sedation of the severely agitated patient who may be violent or aggressive. (Consensus recommendation) (C)
334012
Recommendation Grading
Overview
Title
Adult Psychiatric Patient in the Emergency Department
Authoring Organization
American College of Emergency Physicians
Publication Month/Year
January 1, 2017
Last Updated Month/Year
January 16, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
This clinical policy from the American College of Emergency Physicians addresses key issues for the diagnosis and management of adult psychiatric patients in the emergency department.
Target Patient Population
Patients with psychiatric symptoms
Inclusion Criteria
Female, Male, Adolescent, Adult, Older adult
Health Care Settings
Emergency care
Intended Users
Paramedic emt, nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Management
Diseases/Conditions (MeSH)
D011570 - Psychiatry, D004635 - Emergency Medicine, D000296 - Adolescent Psychiatry, D004637 - Emergency Services, Psychiatric
Keywords
emergency medicine, psyciatric, psychiatry
Source Citation
Ann Emerg Med. 2017;69:480-498.
Methodology
Number of Source Documents
39
Literature Search Start Date
January 1, 2005
Literature Search End Date
September 3, 2015