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INTRODUCTION

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.

BASIC APPROACH

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.

TABLE 38-1Common Psychiatric Presentations and Clinical Responses

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.

DIAGNOSIS

Disaster Triage: Psychological Simple Triage and Rapid Treatment

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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