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Chapter 11 - The patient with anxiety disorders in the emergency department

from Section 3. - Psychiatric illnesses

Published online by Cambridge University Press:  05 April 2013

By
Mila L. Felder  and
Marcia A. Perry
Edited by
Leslie S. Zun
Edited in association with
Lara G. Chepenik  and
Mary Nan S. Mallory
Leslie S. Zun
Affiliation:
Department of Emergency Medicine, Mt Sinai Hospital, Chicago
Lara G. Chepenik
Affiliation:
Yale University School of Medicine
Mary Nan S. Mallory
Affiliation:
University of Louisville, School of Medicine
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Summary

Anxiety disorders are among the most common psychiatric presentations to the emergency department (ED). The ability to differentiate anxiety symptoms and disorders from acute life-threatening conditions is paramount in providing treatment that is thorough, safe, and accurate. This can be particularly challenging when dealing with the time constraints faced in the ED, and financial limitations encountered in the un-insured and the underinsured patients. The Panic Screen Score (PSS) is one tool available for evaluation of ED patients presenting with unexplained chest pain which may be used to help determine prevalence as well as guide referral for further mental health evaluations. There is evidence to support both the efficacy and effectiveness of cognitive behavioral therapy (CBT) as an acute treatment for adult anxiety disorder. In cases where pharmacological therapy is necessary in the ED and even more rarely, upon discharge, short-acting benzodiazepines such as Lorazepam and Alprazolam can be used.

Keywords

emergency departmentpsychiatric patientsdrug testingAmerican College of Emergency Physicianscognitionalcohol testing
Type
Chapter
Information
Behavioral Emergencies for the Emergency Physician , pp. 76 - 82
Publisher: Cambridge University Press
Print publication year: 2013

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