A colleague just sent me a copy of an article via our university interlibrary loan system on using a decision support tool for detecting delirium in patients with dementia. The authors describe the feasibility pilot using the electronic medical record (EMR) to assist in nursing assessment and detection of delirium in patients with dementia. The […]
This is another Dirty Dozen, this time on the common elements in psychotherapy. If there were not a Dirty Dozen on psychotherapy on this blog, it would just not be a both/and site, would it? And it would tend to feed the notion that psychiatrists are all about the pills. So this is a presentation […]
This is a variation on the Dirty Dozen, for Earth Day 2012. I wrote the poem for Earth Day and for my wife, Sena, who is an avid gardener and who is very close to the earth–and my heart. Hold On to Me At the root of my heart, Where the mystery starts, In your heart […]
Welcome to another Dirty Dozen with video about Factitious Disorder and Malingering. As a psychiatric consultant in the general hospital, I’m infrequently called upon to render an opinion about and assistance with managing patients who are thought to be lying about symptoms (usually medical although factitious disorder can be about psychological symptoms as well). The […]
Catatonia is a complex neuromotor disorder which is not well-studied, partly because of its relative rarity. It can be seen in both medical and psychiatric disorders and is eminently treatable sometimes with benzodiazepines and most importantly, electroconvulsive therapy (ECT), which can be life-saving. Patients can suffer and even die from such medical complications as dehydration and […]
This is one of those videos I promised to inflict on you and, of course, its about delirium. The nurse on our delirium Quality Improvement project asked for volunteers to give a CEU talk to nurses in the hospital because she’s planning to roll out the Delirium Observation Screening Scale (DOSS) to the rest of […]
In some ways the search for the Holy Grail of delirium screening scales is something of a beauty contest. You can take one look at some of them and tell pretty much whether or not nurses are going to accept them based on the level of written complexity. Take the NEECHAM for example. I can […]
So for a couple of months, our front yard fountain has not been working. The fountain is one of those massive affairs with a pedestal and three stacked bowls, the heaviest on the bottom. My wife, Sena, and I finally figured out that the pump had given up the ghost. I’m not the handiest person in the world, and I was […]
This is another Dirty Dozen and it’s about managing alcohol withdrawal. I’ve included links to my other blog posts about this topic. An excerpt from Chapter 21 on alcohol withdrawal management in Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry (a book edited by myself and Dr. Robert G. Robinson): Because of toxicity concerns, the use […]
Thank you, all of you who have given me positive feedback on the blog so far. Give yourselves a big hand. And don’t forget to vote above. NOTE THE POLL HAS An ADDITION: The SQiD (Single Question in Delirium), which got a vote in the “Other” slot! Who knew? Recall the study about the SQiD: […]
We had another excellent presentation at our weekly case conference, Clinical Problems in Consult Psychiatry (CPCP). This one is on the intersection between sleep deprivation and delirium, especially delirium in the intensive care unit (ICU). A common challenging question for consultation psychiatrists is how to manage the sleep-wake cycle disturbance in the ICU patient who […]
Well Said…