Psychiatric crash cart: treatment strategies for the emergency department

Emergency department staff are often frustrated when treating patients with psychiatric disorders. Nurses may feel that these patients are taking time away from the truly sick and may react by avoiding, ignoring, or using force with patients with psychiatric disorders. Psychiatric patients will often present with exacerbations of their illnesses, as do our patients with medical conditions. Ignoring or disregarding these symptoms will worsen them, much like ignoring dyspnea will cause a patient to deteriorate physically. Instead, it is important to understand the common psychiatric diagnoses and their associated symptomology. Symptom management is critical in the treatment of patients with psychiatric disorders; it reduces anxiety, builds trust, and allows the patients to feel safer. The staff is able to enlist the cooperation of the patients to stay in control, not only reducing disruption in the ED but also creating a better patient experience. Establishing a therapeutic relationship with patients also furthers this goal.