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…
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.
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Last Updated on February 28, 2023