Abstract
Attention to the intersections of mental health and physical health in emergency medicine is long-standing. Patients’ and families’ emotional responses to the acute physical presentations that characterize this care context can be as diverse as the presentations themselves; common themes relate to struggling with ambiguities about what will happen to sick or injured patients, fears about one’s own or a loved one’s life and survival, and/or misplaced anger directed at each other, healthcare providers, or office staff. Behavioral health presentations per se – without clear physical components – are also commonplace here. Suicidality (and the severe depression that can fuel it), anxiety and panic, psychosis, and any variety of states defined by psychological decompensation can bring patients to the emergency department (ED). Moreover, the worries and fears maintained by the family members who bring them can echo those that we see in response to straightforward physical injuries or conditions.
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Notes
- 1.
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Literature
Adams, J. (2012). Emergency medicine: Clinical essentials. Philadelphia, PA: Elsevier & Saunders.
Hughes, T., & Cruickshank, J. (2011). Adult emergency medicine at a glance. Hoboken, NJ: Wiley-Blackwell.
Mahadevan, S., & Garmel, G. (2012). Introduction to clinical emergency medicine (2nd ed.). New York, NY: Cambridge University Press.
Wyatt, J., Illingworth, R., Grahm, C., & Hogg, K. (2017). Oxford handbook of emergency medicine (4th ed.). New York, NY: Oxford University Press.
Measures/Instruments
Alcohol Use Disorders Identification Test (AUDIT). http://www.integration.samhsa.gov/AUDIT_screener_for_alcohol.pdf
CAGE Alcohol Questionnaire. http://www.integration.samhsa.gov/images/res/CAGEAID.pdf
Columbia-Suicide Severity Rating Scale. http://www.integration.samhsa.gov/clinical-practice/Columbia_Suicide_Severity_Rating_Scale.pdf
Patient Health Questionnaire (PHQ-9). http://www.integration.samhsa.gov/images/res/PHQ%20-%20Questions.pdf
Organizations/Associations
Substance Abuse and Mental Health Services Administration (SAMHSA)/Guide to Screening Tools. http://www.integration.samhsa.gov/clinical-practice/screening-tools
Substance Abuse and Mental Health Services Administration (SAMHSA)/Guide to Suicide Prevention. http://www.integration.samhsa.gov/clinical-practice/suicide-prevention
Suicide Prevention Resource Center. http://www.sprc.org/ed-guide
Glossary of Important Terms for Care in Emergency Medicine
- ABCs
-
Essential steps and foci used by both medical professionals and lay persons when attending to a patient during an emergency; stands for airway with cervical spine control, breathing, circulation with control of bleeding.
- Acute
-
A sudden, unexpected, and often intense health condition.
- Agonal
-
A major negative change in a patient’s health condition, usually preceding death (e.g., complete cessation of breathing, dire change in EKG).
- ALS
-
Advanced life support; includes life-saving protocols and skills that include both basic life support and efforts to facilitate circulation and provide an open airway and adequate ventilation for breathing.
- AMA
-
Against medical advice; refers to when a patient leaves a hospital and/or discontinues treatment against the advice of his or her care provider.
- BLS
-
Basic life support; refers to care provided to victims of a life-threatening illnesses or injuries until they can be admitted to a hospital for full medical attention.
- BSA
-
Burn surface area; refers to the total percentage area of a patient’s body that is burned.
- Chest film
-
An x-ray of patient’s chest.
- Coag panel
-
A test to assess blood clotting capability.
- CPR
-
Cardiopulmonary resuscitation; this is an emergency procedure that combines chest compressions and (often) artificial ventilation so as to manually preserve brain function until further measures can be taken to restore spontaneous breathing and blood circulation in a person who is experiencing cardiac arrest.
- Crasher
-
A person who passes out in the ED (often a family member who is upset about what is happening with their loved one).
- DB
-
Dead body; patient is deceased.
- DNR
-
Do not resuscitate; a directive that this formally requested or ordered for terminally ill or injured patients.
- DOA
-
Dead on arrival; patient arrived to care facility deceased.
- Dyspnea
-
Shortness of breath; refers to difficult and/or labored breathing. This condition is associated with a myriad of acute and chronic physical conditions.
- GSW
-
Gunshot wound.
- LOC
-
Loss of consciousness.
- MVA
-
Motor vehicle accident; can refer to incidents involving cars/trucks or motorcycles.
- NS
-
Normal saline; refers to a mixture of sodium chloride and water. NS is used for a variety of purposes, including (but not limited to) cleaning wounds, treating dehydration (when injected intravenously), wetting dry eyes, and diluting medications.
- Rape kit
-
A box or package containing envelopes hair, sperm, and blood samples from a rape victim; also contains formal reporting paperwork.
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Kassekert, R., Mendenhall, T. (2018). Medical Family Therapy in Emergency Medicine. In: Mendenhall, T., Lamson, A., Hodgson, J., Baird, M. (eds) Clinical Methods in Medical Family Therapy. Focused Issues in Family Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-68834-3_7
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