Acute psychosis
Revision as of 17:03, 24 March 2015 by Kghaffarian (talk | contribs) (Created page with "==Background== *Caused by many psychiatric and medical conditions *Examples: schizophrenia, mania ==Clinical Presentation== *Agitation *Restlessness *Irritability *Decreased a...")
Background
- Caused by many psychiatric and medical conditions
- Examples: schizophrenia, mania
Clinical Presentation
- Agitation
- Restlessness
- Irritability
- Decreased attention
- innappropriate or hostile behaviors
Differential Diagnosis
Diagnosis
- Vital signs
- Blood glucose
- signs or symptoms of intoxication or withdrawal
- signs of trauma
Management
- Non-pharmacologic
- Verbal de-escalation
- Offer comforting items: blanket, meal, pillow, etc
- Quiet room
- Physical restraints
- should administer medications if restraints used (decreases restraint time)
- Pharmacologic: Goal is to calm pt without oversedation
- No history of psychosis
- Haloperidol 0.5mg-5mg + lorazepam 0.25-2mg (PO/IM/IV)
- Consider adding benztropine 0.5-2mg OR diphenhydramine 25-50mg (PO/IV/IM)
- reduces dystonia or EPS
- Consider risperidone 0.5-2mg PO OR olanzapine 2.5-20mg (PO/IM/SL) OR ziprasidone 10-20mg IM
- No history of psychosis