Use of Telepsychiatry in Pediatric Emergency Room to Decrease Length of Stay for Psychiatric Patients, Improve Resident On-Call Burden, and Reduce Factors Related to Physician Burnout

2019 ◽  
Vol 25 (9) ◽  
pp. 828-832 ◽  
Author(s):  
Aaron Reliford ◽  
Blessing Adebanjo
Keyword(s):  
Length Of Stay ◽  
Emergency Room ◽  
Psychiatric Patients ◽  
Pediatric Emergency ◽  
Physician Burnout

scholarly journals A Retrospective Review of Antipsychotic Medications Administered to Psychiatric Patients in a Tertiary Care Pediatric Emergency Department

2019 ◽  
Vol 24 (3) ◽  
pp. 234-237
Author(s):  
Frances Rudolf ◽  
Kathryn Hollenbach ◽  
Keri L. Carstairs ◽  
Shaun D. Carstairs
Keyword(s):  
Length Of Stay ◽  
Antipsychotic Medication ◽  
Pediatric Patients ◽  
Psychiatric Patients ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Antipsychotic Medications ◽  
Intramuscular Dose ◽  
Oral Medications ◽  
Chief Complaints

OBJECTIVES An increasing number of pediatric patients with psychiatric chief complaints present to emergency departments (EDs) nationwide. Many of these patients require treatment with antipsychotic medications to treat agitation. We sought to examine the use of antipsychotic medications in pediatric patients presenting to a tertiary care pediatric ED. METHODS We performed a retrospective electronic medical record review of patients presenting to a tertiary care pediatric hospital from January 2009 through February 2016 with a psychiatric chief complaint who received an antipsychotic medication in the ED. RESULTS A total of 229 patients were identified, 54.1% of whom were male. Mean age was 14.4 ± 2.6 years. Commonly administered medications included olanzapine (51.1%), aripiprazole (26.6%), haloperidol (24.0%), and risperidone (11.8%). Eighty-seven patients (38.0%) were given at least 1 intravenous or intramuscular dose of antipsychotic medication. A total of 113 patients (49.3%) received only 1 antipsychotic medication, 65 (28.4%) received 2, 30 (13.1%) received 3, and 21 (9.2%) received 4 or more antipsychotics. Median length of stay (minutes) increased significantly with increasing number of medications administered (p < 0.001). Length of stay was significantly shorter in patients given only oral medications (675.6 minutes, IQR 418–1194) compared to those given at least one intramuscular or intravenous dose (951 minutes, IQR 454–1652) (p = 0.014). CONCLUSIONS In this retrospective series, the majority of patients were treated with newer oral antipsychotics. Administration of multiple medications was associated with a significantly longer length of stay in the ED, as was parenteral administration of antipsychotics.

scholarly journals Psychiatric Patients Boarding at the Emergency Department: Length of Stay and Consequences

2019 ◽  
Vol 4 (4) ◽  
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Emergency Room ◽  
Psychiatric Patients ◽  
Community Services ◽  
The State ◽  
Government Hospital ◽  
Health Strategy ◽  
National Mental Health ◽  
Psychiatric Beds

Objectives: In this research audit we look at the length of stay for psychiatric patents boarding at the emergency room at Hamad General Hospital which is the largest government hospital in the state of Qatar. We also looked at other parameters like, the number of psychiatric patients who leave the ER against medical advice of their own will, whether they return afterwards within a week or not, and also, how many of the boarding patents were treated and discharged without being transferred to the psychiatry hospital. Significant Findings: It was found that out of the 357 boarding patents, only 95 (26.6%) spent less than 12 hours in the ED, and a cumulative of 115 patents spent more than 24 hours in the ED. What was also found was that from the 65 patents discharged y the psychiatry liaison team only 3 returned to the ED within 1 week. Principal Recommendations: To find a safer alternative to patients boarding in the emergency room, in the form of increased in patent beds in Psychiatry, increased flow to community services in additon to adequuate staffing and ER resources including staff and doctors to care for the boarding patents. Conclusion: After reviewing the national mental health strategy, as mentioned in the introduction as well, it is deemed that a need of 319 psychiatric beds is present in the state of Qatar currently. The mental health strategy also highlights plans for expansion of psychiatric services in all the various disciplines like community and home care as well, in order to reduce the number of patents boarding in the ER which goes in line with the recommendations that are produced through this audit.

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