Carubia Beau, Becker Amy, Levine B Harrison
Department of Psychiatry, University of Colorado, Aurora, CO, USA.
B. Harrison Levine, MD, Inc., Denver, CO, USA.
Curr Psychiatry Rep. 2016 Apr;18(4):41. doi: 10.1007/s11920-016-0670-9.
Over the past 15 years, the number of pediatric patients presenting to the emergency room in psychiatric crisis has nearly doubled. Suicidality and aggression are among the most common presenting problems, making it important for providers to have up-to-date knowledge about the assessment and management of these frequently encountered clinical issues. Psychometrically sound suicide risk assessment tools are available for use in the emergency room setting, which can be administered efficiently with minimal provider training. Rates of off-label medication use in the pediatric population continue to increase and are often used in the management of acute agitation in the pediatric population. The current literature will be reviewed and summarized for application in emergent treatment settings. Overall, evidence to inform best practice is limited, leading to opportunities for innovation in health care delivery, the development of new research aims, and discussion of challenging clinical dilemmas.
在过去15年里,因精神危机前往急诊室就诊的儿科患者数量几乎翻了一番。自杀倾向和攻击行为是最常见的就诊问题,因此医疗人员掌握这些常见临床问题的最新评估和管理知识非常重要。有心理测量学依据的自杀风险评估工具可在急诊室环境中使用,只需对医疗人员进行最少的培训就能高效实施。儿科人群中标签外用药的使用率持续上升,常用于儿科急性激越的管理。本文将对当前文献进行综述和总结,以便应用于紧急治疗环境。总体而言,为最佳实践提供依据的证据有限,这为医疗服务的创新、新研究目标的制定以及具有挑战性的临床困境的讨论带来了机遇。