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Psychiatric emergencies in prehospital emergency medical systems: a prospective comparison of two urban settings.
Gen Hosp Psychiatry 2008 Jul-Aug; 30(4):360-6GH

Abstract

BACKGROUND

Psychiatric emergency situations (PES) are of high importance to the German prehospital physician-based emergency medical system. So far, however, no prospective studies regarding the incidence of PES have been performed, neither have effects of training programs on diagnostic and therapeutic accuracy been studied.

METHOD

The protocols of two emergency medical services (EMS) were collected and analyzed prospectively. Emergency physicians (EPs) in Kaiserslautern (KL) attended a standardized educational program and underwent daily supervision. EPs in Homburg (HOM) had not been informed about the study. In KL, sociodemographic variables were collected. An investigator who was not involved in the individual EMS mission assessed the correct classification of PES.

RESULTS

Among all calls for an EP, 11.8% were classified as PES. There was no difference between the two centers. Correct classification of PES in KL was significantly higher than that in HOM (94.3% vs. 80.6%). Documentation of suicidal behavior was deficient in both centers. EPs in KL gave verbal crisis intervention significantly more often, administered less medication overall, and dispensed more specific drugs in psychotic disorders and significantly less drugs in substance abuse disorders. Patients were more often treated at the scene and were less often transported to a hospital. Some sociodemographic variables were associated with psychiatric morbidity of treatment.

CONCLUSION

Accounting for 12% of all missions, psychiatric emergencies are a frequent reason for calls for EPs, equaling trauma-related and neurological emergencies. The most frequent reasons for calls were alcohol intoxication, states of agitation and suicidal behavior. The diagnostic and therapeutic accuracy of EPs may be improved with a concise standardized teaching program.

Authors+Show Affiliations

Department of Psychiatry and Psychotherapy, The Saarland University Hospitals, Homburg, Germany. pajonk@klinik-dr-fontheim.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

18585541

Citation

Pajonk, Frank-Gerald, et al. "Psychiatric Emergencies in Prehospital Emergency Medical Systems: a Prospective Comparison of Two Urban Settings." General Hospital Psychiatry, vol. 30, no. 4, 2008, pp. 360-6.
Pajonk FG, Schmitt P, Biedler A, et al. Psychiatric emergencies in prehospital emergency medical systems: a prospective comparison of two urban settings. Gen Hosp Psychiatry. 2008;30(4):360-6.
Pajonk, F. G., Schmitt, P., Biedler, A., Richter, J. C., Meyer, W., Luiz, T., & Madler, C. (2008). Psychiatric emergencies in prehospital emergency medical systems: a prospective comparison of two urban settings. General Hospital Psychiatry, 30(4), pp. 360-6. doi:10.1016/j.genhosppsych.2008.03.005.
Pajonk FG, et al. Psychiatric Emergencies in Prehospital Emergency Medical Systems: a Prospective Comparison of Two Urban Settings. Gen Hosp Psychiatry. 2008;30(4):360-6. PubMed PMID: 18585541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychiatric emergencies in prehospital emergency medical systems: a prospective comparison of two urban settings. AU - Pajonk,Frank-Gerald, AU - Schmitt,Patrik, AU - Biedler,Andreas, AU - Richter,Jens Christian, AU - Meyer,Wolfgang, AU - Luiz,Thomas, AU - Madler,Christian, PY - 2007/10/24/received PY - 2008/03/25/revised PY - 2008/03/26/accepted PY - 2008/7/1/pubmed PY - 2008/9/11/medline PY - 2008/7/1/entrez SP - 360 EP - 6 JF - General hospital psychiatry JO - Gen Hosp Psychiatry VL - 30 IS - 4 N2 - BACKGROUND: Psychiatric emergency situations (PES) are of high importance to the German prehospital physician-based emergency medical system. So far, however, no prospective studies regarding the incidence of PES have been performed, neither have effects of training programs on diagnostic and therapeutic accuracy been studied. METHOD: The protocols of two emergency medical services (EMS) were collected and analyzed prospectively. Emergency physicians (EPs) in Kaiserslautern (KL) attended a standardized educational program and underwent daily supervision. EPs in Homburg (HOM) had not been informed about the study. In KL, sociodemographic variables were collected. An investigator who was not involved in the individual EMS mission assessed the correct classification of PES. RESULTS: Among all calls for an EP, 11.8% were classified as PES. There was no difference between the two centers. Correct classification of PES in KL was significantly higher than that in HOM (94.3% vs. 80.6%). Documentation of suicidal behavior was deficient in both centers. EPs in KL gave verbal crisis intervention significantly more often, administered less medication overall, and dispensed more specific drugs in psychotic disorders and significantly less drugs in substance abuse disorders. Patients were more often treated at the scene and were less often transported to a hospital. Some sociodemographic variables were associated with psychiatric morbidity of treatment. CONCLUSION: Accounting for 12% of all missions, psychiatric emergencies are a frequent reason for calls for EPs, equaling trauma-related and neurological emergencies. The most frequent reasons for calls were alcohol intoxication, states of agitation and suicidal behavior. The diagnostic and therapeutic accuracy of EPs may be improved with a concise standardized teaching program. SN - 0163-8343 UR - https://www.unboundmedicine.com/medline/citation/18585541/Psychiatric_emergencies_in_prehospital_emergency_medical_systems:_a_prospective_comparison_of_two_urban_settings_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-8343(08)00044-3 DB - PRIME DP - Unbound Medicine ER -