Physical examination of psychiatric patients who presented at emergency department in a tertiary care hospital in Sultanate of Oman

Abstract

Objective

To examine the completeness of physical assessment of patients presenting with psychiatric problems to the emergency department (ED).

Methods

This was observational study based on a retrospective review of the medical records of patients who attended the ED of Sultan Qaboos university hospital and referred to the on-duty psychiatrist for assessment over a 12-month period. All patients aged 16 years and above, who presented to the ED with a psychiatric complaint were included in the study. A data collection sheet was designed to gather each patient's demographic data such as age and gender, past psychiatric history, nature of the presenting complaints, thoroughness of physical assessment, medications prescribed by the ED doctor prior to psychiatric assessment, and whether the patient was discharged, admitted to a psychiatry.

Results

A total of 202 patients met the inclusion criteria. The mean age of the patients was 34.2 years. Females represented 56% of the sample. The majority of the study group (60.4%) were patients with a documented past psychiatric history. Physical examination was conducted in the ED for 61.4% of the patients, while vital signs were recorded for 68.8% of them. Approximately, 31% of the patients required injectable psychotropic medications as tranquillizers in the ED. Patients with an isolated psychiatric complaint coupled with a documented past psychiatric history were more likely to be referred to the on-call psychiatrist without a physical examination by the ED doctors.

Conclusion

In our institution, not all patients with psychiatric presentations had a complete physical examination by the ED doctors.

Disclosure of interest

The author has not supplied his declaration of competing interest.