Tucci Veronica Theresa, Moukaddam Nidal, Alam Al, Rachal James
Merit Health Wesley, Department of Emergency Medicine, 5001 Hardy Street, Hattiesburg, MS 39402, USA.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1502 Taub Loop, NPC Building 2nd Floor, Houston, TX 77030, USA.
Psychiatr Clin North Am. 2017 Sep;40(3):411-423. doi: 10.1016/j.psc.2017.04.001.
Patients presenting to the emergency department with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, interdisciplinary consensus on medical clearance is lacking, leading to wide variations in quality of care and, quite often, poor medical care. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach. This article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical or physical examination, and common pitfalls in the medical clearance process.
因精神疾病或行为问题前往急诊科就诊的患者，有必要对可能引发、模仿或加重精神症状的潜在身体状况进行检查。然而，目前在医疗许可方面缺乏跨学科共识，导致医疗质量差异很大，而且医疗护理往往很差。精神病学和急诊医学专业指南支持采用量身定制的方法。本文总结了对患有精神疾病患者进行医疗许可的最佳实践方法、病史采集技巧、系统回顾、临床或体格检查以及医疗许可过程中的常见陷阱。
