??????????????????? Psychiatric Emergency

1
???????????????????Psychiatric Emergency

• ??.????????? ?????

2
????????

• ????????????? ??? ??????????????????????????
  ?????? ??????? ???? ????????
• ??????????? ??? ????????????????????????????????
  ?? ????????????????????????????????????? ?????
  ????????? ????????????????

3
???????

• 1. ????????????? ??? aggression
• 2. ?????????????? suicide
• 3. Management ??????????

4
Emergency conditions

• 1. Aggression
• 2. Suicide
• 3. Medical conditions
• 4. Psychosis

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Aggression

• Unpredictable status
• ?????????????????????????? ????
• Past history of aggression ??????????????

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Suicide

• ??????? ????????????????????????
• ???????????????????????????? ???? ??????????
  ??????????????????????????

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High risk suicide

• ??????????
• ?????????????
• Severe depression
• Psychosis
• No supporting system
• ??????????????
• ????????????????????????
• ?????????????????????

8
Medical conditions

• ??????????????? ??????????? ?????????????????????
• - old age (gt40)
• - sudden onset
• - ?? underlying diseases
• - ??????????????????
• - ??????????????????
• - ?????????????????????????
• - ????????????????????

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Acute delirium

• Abnormal of consciousness
• High mortality and morbidity
• Early signs agitation and insomnia
• Medical causes
• Low acetylcholine and high dopamine
• Goals of treatment treatment causes and calm
  down
• Haloperidol is the drug of choice (safety at 1600
  mg./day)

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Psychosis

• ????????????????????????????????????????????
• psychosis ?????????????????????
• 1. ??????? ?????? ?????????? ???????????????
  ?????????????????
• 2. personality change
• 3. no insight

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Management

• 1. ??????????????????????????????????
• 2. ????????????????
• 3. ????????????????????????

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Pitfalls in emergency psychiatry

• Unawareness of aggression
• ?????? suicide
• ?????????????????? ????????? ??????????????
• ???????? ?????????????????? ???????
• ?????????????????????????????? ???????????????????
  ????
• ?????????????????? ???????????????? ??????????
• ?????? ????????????? ?????????????????????