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INTRODUCTION

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All medical practitioners should be able to recognize stress-induced psychiatric illness and be prepared to do basic interventions. Psychiatric help is often not immediately available in austere situations.

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BASIC APPROACH

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In austere medical situations, mental health professionals and psychiatric facilities are usually inadequate or nonexistent. Psychiatric medications may be scarce or of limited variety. The first step for the non-psychiatrist working with patients who have psychiatric disorders is to review Table 38-1. It describes the general approaches for common psychiatric presentations.

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TABLE 38-1Common Psychiatric Presentations and Clinical Responses
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The most critical patients are those with new presentations of psychiatric disorders, including delirium. These symptoms represent serious disease states, often from a systemic disease or drug effect, that may respond to rapid treatment.

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DIAGNOSIS

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Disaster Triage: Psychological Simple Triage and Rapid Treatment

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Disasters represent a special case for psychiatric evaluation and treatment because, no matter their scope, they may generate psychiatric problems for both rescuers and victims. Table 38-2, which is specifically designed for use in disaster settings, helps identify key behavioral symptoms that often signal problems. This model parallels standard triage systems, so is ...

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