Treatment of Psychiatric Emergencies

Psychiatric emergencies, whether due to an underlying psychiatric disorder or not, constitute a significant portion of emergency department (ED) presentations. These emergencies are often characterized by agitation and must be adequately managed to prevent harm to the patient and/or staff. Safety is paramount for all patients. Patients who are manic or psychotic benefit enormously from being restarted on their outpatient medication regimen as soon as possible, whereas the focus with patients complaining of suicidality should first be an adequate level of supervision to avoid self-harm attempts in the ED setting. Substance-related presentations can mimic other entities but carry a high risk of unpredictable behaviors and, unfortunately, a high risk for restraints and emergency medications. Management strategies covered in this article include behavioral interventions, with a special focus on the innovative field of sensory modulation, and pharmacological interventions.