Hospital & community psychiatry
-
Hosp Community Psychiatry · Sep 1992
Case ReportsDo-not-resuscitate orders for depressed psychiatric inpatients.
Many patients, especially those who are elderly and who have chronic medical illnesses, choose to forgo cardiopulmonary resuscitation (CPR) in case of cardiac arrest. The right of mentally competent patients to refuse CPR is supported by ethicists, the courts, and medical associations. ⋯ Survival rates after CPR among elderly patients with chronic medical illnesses are low. Patients and their families need accurate information about the risks and benefits of CPR and about the consequences of refusing the procedure.
-
Hosp Community Psychiatry · Jul 1992
ReviewPrimary health care in the CMHC: a role for the nurse practitioner.
Although persons with chronic mental illness have a high incidence of physical health problems, they are often ill equipped to seek care within complex health care systems and tend to depend on community mental health centers as their only source of regular health care. The authors describe a role for the nurse practitioner in assessing the medical needs of chronic mentally ill outpatients at a community mental health center and in devising strategies to meet those needs. The nurse practitioner's activities include direct physical health screening and treatment, referral for specialized medical services, consultation, research, and staff and patient education.
-
Hosp Community Psychiatry · Jul 1992
ReviewA review of indications for routine EEG in clinical psychiatry.
With increasing recognition of the role of organic factors in the etiology of psychiatric disorders, greater use of neurodiagnostic tests is expected. Clinical electroencephalography (EEG) is a noninvasive, low-cost neurodiagnostic technique widely available in psychiatric hospitals. Based on a review of the literature, the author outlines clinical applications of routine (non-computerized) EEG related to evaluation of organic etiologies and symptoms of dementia, delirium, and lithium toxicity; evaluation before electroconvulsive therapy; and routine screening of patients. Screening EEGs are not recommended in settings in which complete neurological examinations are routinely performed.