This document discusses various psychiatric emergencies and their management. It describes conditions like suicidal threats, violence, panic attacks, catatonia, hysteria, transient situational disturbances, delirium tremens, epileptic furor, acute drug-induced movement disorders, and drug toxicity. For each condition, it outlines signs, potential causes, and recommended emergency treatment approaches such as reassurance, sedation, monitoring safety, fluid replacement, and stopping causative medications. The overall goal of management is to stabilize the patient, prevent harm, and address the underlying psychiatric condition.
Nature and scope of meantal health nursing - Presented By Mohammed Haroon Ra...Haroon Rashid
Subject - Mental Health Nursing and topic is Nature and Scope of Mental health nursing , Presented by Mohammed Haroon Rashid, Basic B.Sc Nursing 3rd Year in Florence College of Nursing
Personality disorder ppt MENTAL HEALTH NURSINGvihang tayde
Most definition of normal personality includes some or all of the following features,
Present since adolescence.
Stable overtime despite fluctuations in mood.
Manifest in different environment.
Recognizable to friends and acquaintance.
The basic about the principles of psychiatric nursing , what all are the basic we have to follow while providing care to the psychiatric patients in hospital and in the community area
mania is an alteration in mood that is characterized by extreme happiness, extreme irritability, hyperactivity, little or no need for sleep. the main etiological factors include biological factors, biochemical influences, physiological factors, and psycho social theories. mania is broadly classified into three categories- hypo mania, acute mania and delirious mania. there are three types of treatment for mania- pharmacological treatment, psycho-social treatment and ECT.
Electroconvulsive Therapy is still being used. It is a procedure usually done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure.
Almost all people affected by emergencies will experience psychological distress which for most people will improve over time.People with severe mental disorder are especially vulnerable during emergencies and need access to mental health care and other basic needs.
Nature and scope of meantal health nursing - Presented By Mohammed Haroon Ra...Haroon Rashid
Subject - Mental Health Nursing and topic is Nature and Scope of Mental health nursing , Presented by Mohammed Haroon Rashid, Basic B.Sc Nursing 3rd Year in Florence College of Nursing
Personality disorder ppt MENTAL HEALTH NURSINGvihang tayde
Most definition of normal personality includes some or all of the following features,
Present since adolescence.
Stable overtime despite fluctuations in mood.
Manifest in different environment.
Recognizable to friends and acquaintance.
The basic about the principles of psychiatric nursing , what all are the basic we have to follow while providing care to the psychiatric patients in hospital and in the community area
mania is an alteration in mood that is characterized by extreme happiness, extreme irritability, hyperactivity, little or no need for sleep. the main etiological factors include biological factors, biochemical influences, physiological factors, and psycho social theories. mania is broadly classified into three categories- hypo mania, acute mania and delirious mania. there are three types of treatment for mania- pharmacological treatment, psycho-social treatment and ECT.
Electroconvulsive Therapy is still being used. It is a procedure usually done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure.
Almost all people affected by emergencies will experience psychological distress which for most people will improve over time.People with severe mental disorder are especially vulnerable during emergencies and need access to mental health care and other basic needs.
Psychiatric emergency is a condition where in the patient has disturbances of thought, affect and psychomotor activity leading to a threat to his existence (suicide), or threat to the people in the environment (homicide).
Psychiatric emergencies are acute changes in behavior that negatively impact a patient's ability to function in his or her environment. ... The screening assessment also involves a psychiatric safety check to explore for suicidal ideation, homicidal ideation, or patients' inability to care for themselves.
Specific learning disorder - reading disorder, mathematics disorder, and disorder of written expression and learning disorder NOS .
neurodevelopmental disorder produced by the interactions of genetic and environmental factors that influence the brain's ability to perceive or process verbal and nonverbal information efficiently.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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2. Psychiatric emergency
• Is a condition wherein the patient has
disturbances of thought, affect and
psychomotor activity
• leading to a threat to his existence (suicide),
or threat to the people in the environment
(homicide).
3. • This condition needs immediate intervention to
• safeguard the life of the patient,
• bring down the anxiety of the family members
and
• enhance emotional security to others in the
environment.
4. Common psychiatric emergencies are
• Suicidal threat
• Violent, aggressive behaviour and excitement
• Panic attacks
• Stupor and catatonic syndrome
• Hysterical attacks
• Transient situational disturbances
5. Organic psychiatric emergencies are
• Delirium tremens
• Epileptic furor
• Acute drug induced extra pyramidal symptoms
• Drug toxicity
6. Suicidal threat
• Suicide is a type of deliberate self-harm and is
defined as an intentional human act of killing
oneself.
7. Etiology
• Psychiatric Disorders
• Major depression
• Schizophrenia
• Drug or alcohol abuse
• Dementia
• Delirium
• Personality disorder
• Physical Disorders
• Patients with incurable or painful physical
disorders like, cancer and AIDS.
8. • Psychosocial Factors
• Failure in examination
• Dowry difficulties
• Marital difficulties
• Loss of loved object
• Isolation and alienation from social groups
• Financial and occupational difficulties
9. Risk Factors for Suicide
• Age
• males above 40years of age
• females above 55years of age
• Sex
• men have greater risk of completed suicide.
• suicide is 3 times more common in men
• women have higher rate of attempted suicide
• Being unmarried, divorced, widowed or separated
• Having a definite suicidal plan
• History of previous suicidal attempts
• Recent losses
10. Major depression:
• one of the commonest conditions associated with a high risk
of suicide.
• Suicide is due to pervasive and persistent sadness;
• pessimistic cognitions concerning the past, present and
future; delusions of guilt, helplessness, hopelessness and
worthlessness;
• and derogatory voices urging him to take his life.
• The risk of suicide is more when the acute phase has passed
and the characteristic psychomotor retardation has improved.
• This is so because the patient has more energy to carry out his
suicidal plans now
11. Schizophrenia:
• the presence of associated depression,
• young age and
• High levels of premorbid functioning (especially during college
education).
• People in this risk group are more likely to realize the
devastating significance of their illness more than other
groups of schizophrenic patients do, and see suicide as a
reasonable alternative.
12. Mania:
• This is usually the result of grandiose ideation: the patient
may believe that he is a great person, or wish to prove his
supernatural powers.
• With this intent in mind, he may carry out some dangerous
activity that can cost him his life.
Drug or alcohol abuse:
Suicide among alcoholics
• can be due to depression in the withdrawal phase.
• Also, the loss of friends and family, self-respect, status, and a
general realization of the havoc alcohol has created in his life
can cause the individual to wish to die.
13. Personality disorder:
• Individuals with histrionic and borderline traits may
occasionally attempt suicide.
Organic conditions:
Conditions such as
• delirium and dementia due to changes of mood like anxiety
and depression may also induce suicidal tendency.
14. Management
• Beware of suicidal signs.
• Monitor the patient’s safety needs.
• Encourage verbal communication of suicidal
ideas.
• Enhance self-esteem of the patient.
15. SUICIDAL SIGNS
• suicidal threat
• writing farewell letters
• giving away treasured articles
• making a will
• closing bank accounts
• appearing peaceful and happy after a period of depression
• refusing to eat or drink, maintain personal hygiene.
16. 2. Monitoring the patient's safety needs:
• take all suicidal threats or attempts seriously
and notify psychiatrist
• search for toxic agents such as drugs/ alcohol
• do not leave the drug tray within reach of the
patient, make sure that the daily medication is
swallowed
• remove sharp instruments such as razor
blades, knives, glass bottles from his
environment.
• remove straps and clothing such as belts,
neckties
• do not allow the patient to bolt his door on
the inside, make sure that somebody
accompanies him to the bathroom
17. • patient should be kept in constant observation and should
never be left alone
• have good vigilance especially during morning hours
• spend time with him, talk to him, and allow him to ventilate his
feelings
• encourage him to talk about his suicidal plans Imethods
• if suicidal tendencies are very severe, sedation should be given
as prescribed
18. 3. Encourage verbal communication of suicidal ideas as well as
his/her fear and depressive thoughts.
A 'no suicidal' pact may be signed, which is a written agreement
between the client and the nurse, that client will not act on
suicidal impulses, but will approach the nurse to talk about
them.
4. Enhance self-esteem of the patient by focusing on his
strengths rather than weaknesses. His positive qualities should
be emphasized with realistic praise and appreciation. This fosters
a sense of self-worth and enables him to take control of his life
situation.
19. Violent behaviour
• This is a severe form of aggressiveness.
• patient will be irrational, uncooperative,
delusional and assaultive.
20. Management
• The first step should be to remove the
chains – to remove humiliation
• Talk to the patient and see if he responds.
Firm and kind approach by the nurse is
essential.
• Usually sedation is given. Common drugs
used are: diazepam 10-20mg, IV haloperidol
10-20mg; chlorpromazine 50-100mg IM.
• Once the patient is sedated, take careful
history from relatives; rule out the possibility
of organic pathology. In particular check for
history of convulsions, fever, recent intake of
alcohol, fluctuations of consciousness.
21. • Carry out complete physical examination.
• Send blood specimens for hemoglobin, total cell count, etc.
• Look for evidence of dehydration and malnutrition.
If there is severe dehydration, glucose saline drip may be
started.
• • Have less furniture in the room and remove sharp
instruments, ropes, glass items, ties, strings, match boxes, etc.
from patient's vicinity.
• • Keep environmental stimuli, such as lighting and noise levels
to a minimum; assign a single room; limit interaction with
others.
22. • Stay with the patient as hyperactivity
• increases to reduce anxiety level and
foster a feeling of security.
• Redirect violent behavior with physical outlets such as
exercise, outdoor activities.
• Encourage the patient to 'talk out' his aggressive feelings,
rather than acting them out.
• If the patient is not calmed by talking down and refuses
medication, restraints may become necessary.
• Following application of restraints, observe patient every 15
minutes to ensure that nutritional and elimination needs are
met. Also observe for any numbness, tingling or cyanosis in the
extremities. It is important to choose the least restrictive
alternative as far as possible for these patients.
23. • be sure that the patient has no weapons in his possession
before approaching him.
• if patient is having a weapon ask him to keep it on a table or
floor rather than fighting with him to take it away.
• keep something like a pillow, mattress or blanket wrapped
around arm between you and the weapon.
• distract the patient momentarily to remove the weapon
(throwing water in the patient's face, yelling etc).
• Give prescribed antipsychotic medications.
24. Panic attacks
• Episode of acute anxiety or panic as a part of
psychotic or neurotic illness.
• The patient will experience palpitations,
sweating, tremors, feelings of choking,
chest pain, nausea, abdominal distress, fear
of dying, paresthesias, chills or hot flushes.
26. Catatonic stupor
• Stupor is a clinical syndrome of akinesis and
mutism but with relative preservation of
conscious awareness.
• Catatonic signs are : mutism, negativism,
stupor, ambitendency, echolalia, echopraxia,
automatic obedience, posturing, mannerisms,
stereotypies, etc.
27. Management
• Ensure patent airway
• Administer IVfluids
• Collect history and perform physical examination
• Draw blood for investigations before starting
any treatment
• Other care is same as that for an unconscious
patient
28. Hysterical attacks
• A hysteric may mimic abnormality of any
function which is under voluntary control.
– Hysterical fits
– Hysterical ataxia
– Hysterical paraplegia
29. Management
• Hysterical fit must be distinguished from genuine fits for
differences between hysterical and epileptic seizures).
• As hysterical symptoms can cause panic among relatives,
explain to the relatives the psychological nature of symptoms.
Reassure that no harm would come to the patient.
• Help the patient realize the meaning of symptoms, and help
him find alternative ways of coping with stress.
• Suggestion therapy with IV pentothal may be helpful in some
cases.
30. Transient situational disturbances
• These are characterized by disturbed feelings
and behaviour occurring due to overwhelming
external stimuli.
33. Management
• Keep the patient in quiet and safe
environment.
• Sedationdiazepam 10mg or lorazepam 4 mg
IV, followed by oral administration.
• Fluid and electrolyte balance
• Reassure the patient and family
34. Epileptic furor
• Following epileptic attack patient may behave
in a strange manner and become excited or
violent.
36. Acute drug induced EPS
• Antipsychotics can cause a variety of
movement related side effects, collectively
known as EPS.
• Neuroleptic malignant syndrome is the
complication.
37. Management
• Stop the causative drug.
• Cool the patients body temperature
• Maintain Fluid and electrolyte balance
• Diazepam for muscle relaxation
• Dantrolene to treat malignant hyperthermia
• Bromocriptine, amantadine and Ldopa
have been used.
38. Drug toxicity
• It can be accidental or suicidal.
• A detailed history should be collected and
symptomatic treatment instituted.
• Very common drug is Lithium
• The symptoms include drowsiness, vomiting,
abdominal pain, confusion, blurred vision,
acute circulatory failure, stupor and coma,
generalized convulsions, oliguria and death.
39. Management
• Administer oxygen
• Start IV line
• Assess for cardiac arrhythmias
• Refer for hemodialysis
• Administer anticonvulsants