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Chapter 31 - Disaster and terrorism emergency psychiatry

from Section 5. - Special populations

Published online by Cambridge University Press:  05 April 2013

By
Michael S. Pulia
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

This chapter focuses on the essential elements of an immediate post-disaster assessment and treatment plan for emergency physicians (EPs). The increasing frequency and impact of natural disasters combined with the ever-present threat of terrorism make the management of disaster victims an essential skill for the EP. Dissociation in disaster victims can be difficult to distinguish from delirium due to medical causes. After ruling out any serious medical issues which require stabilization, the focus should shift to assessing the degree of traumatic exposure and individual risk factors for adverse psychiatric outcomes. The concept of acute psychiatric care for victims of trauma is derived from the experience of military psychiatrists in handling traumatized soldiers. Various clinical trials have examined the role of propranolol in traumatic memory consolidation and as a potential agent for post-traumatic stress disorder (PTSD) prevention in traumatized emergency department (ED) patients.

Keywords

physical restraintseclusionketaminelorazepampharmacologyhaloperidolchemical restraintemergency department
Type
Chapter
Information
Behavioral Emergencies for the Emergency Physician , pp. 230 - 234
Publisher: Cambridge University Press
Print publication year: 2013

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