Faculty Collaboration Database

Emergency physician practices and requirements regarding the medical screening examination of psychiatric patients. Acad Emerg Med 2002 Jan;9(1):88-92

Date

01/05/2002

Pubmed ID

11772676

DOI

10.1111/j.1553-2712.2002.tb01173.x

Scopus ID

2-s2.0-0036143707 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

OBJECTIVE: To describe the testing requirements and practices of emergency physicians (EPs) when conducting a medical screening examination of psychiatric patients.

METHODS: An anonymous survey was developed and mailed to 500 EPs randomly selected through American College of Emergency Physicians membership rolls.

RESULTS: Two hundred ninety surveys were returned (58%). Eighty-five percent of the respondents were male, 70% practiced in a community setting and 28% in an academic setting, 58% were emergency medicine (EM) residency-trained, and 88% were EM board-certified or board-eligible. Ninety-eight percent stated they were actively involved with the psychiatric medical screening exam (PMSE). Routine testing was required by 35% of the respondents, with 16% being required by ED protocol, and 84% by the psychiatrist/psychiatric institute. Of those with required testing, tests required were: complete blood cell count (56%), electrolytes (56%), serum alcohol (85%), serum toxicology screen (31%), urine toxicology screen (86%), electrocardiogram (18%), liver function test (16%), blood urea nitrogen (45%), and creatinine (40%). Many clinicians believed that certain tests were unnecessary as part of a PMSE. There was no statistical difference between the opinions of the physicians required to test and those not required to test in terms of which tests they thought were a necessary part of a PMSE regardless of the patient's clinical presentation. The EM-trained physicians were also found to be significantly less likely to think certain tests were necessary for the PMSE when compared with the non-EM-trained physicians.

CONCLUSIONS: Routine testing was required as part of the medical screening examination of psychiatric patients for only one-third of the respondents. Few respondents believed that any of these tests were necessary. Emergency medicine-trained physicians were less likely to feel that routine testing was necessary.

Author List

Broderick KB, Lerner EB, McCourt JD, Fraser E, Salerno K

MESH terms used to index this publication - Major topics in bold

Adult
Attitude of Health Personnel
Chi-Square Distribution
Confidence Intervals
Data Collection
Diagnostic Tests, Routine
Emergency Medicine
Emergency Service, Hospital
Female
Humans
Interview, Psychological
Male
Mental Disorders
Middle Aged
Neuropsychological Tests
Physical Examination
Practice Patterns, Physicians'
Probability
Surveys and Questionnaires
United States