What’s Your Diagnosis? PTSD Symptoms

Welcome to this month’s What’s Your Diagnosis Challenge!

But before we begin, check to see if you got last month’s case on Pelvic Inflammatory Disease: Diagnosis and Treatment in the Emergency Department correct.

Case Presentation: An Evidence-Based Approach to Emergency Department Patients at Risk for Posttraumatic Stress Disorder Symptoms  

A 21-year-old woman with a stab wound to the arm is anxious, upset, and having difficulty focusing and answering questions…   

  • The patient recalls a similar violent injury from her past and appears to struggle to answer general questions from the treating team. There is a record of antidepressant medication in her chart. 
  • Her injuries are mild, and she is stable. After being evaluated by emergency clinicians and the surgical consult team, she remains anxious-appearing and tearful. 
  • You suspect that her recovery may be complicated, given her emotional state. 
  • You wonder whether a mental health consultation is indicated, and whether you can even get one on an emergent basis… 

Case Conclusion

In a calm manner, a member of the treating team made sure the patient knew that she was in a safe place and asked whether her basic physiological needs were met (eg, water, food, etc). They asked her whether there was a support person they could call, given that she was going through a difficult time. Following this initial level of support, the patient returned a high score on the PAS screening for both PTSD and depression in the ED, and her pre-risk and peri-risk factors were consistent with a chronic PTSD trajectory. You asked for a behavioral health consult in the ED prior to discharge and referred her to outpatient behavioral health follow-up. She began early intervention for ASD and continued to follow up with behavioral health. 

Click to review this Emergency Medicine Practice Issue, PTSD Symptoms

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Last Updated on February 28, 2023

One thought on “What’s Your Diagnosis? PTSD Symptoms

  1. She needs both a mental health and social worker consult to investigate if she is the victim of intimate partner abuse and/or trafficking. If she is, and those problems are not addressed, then just treating the stab wound will result in her going back to life-threatening situations. If those situations are possible then she needs a victim advocate to help work her through the system to help keep her safe and to not recant any outcry.

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