Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.

14Oct/11Off

Beyond the Telepsych and Diversion

Demetri Tavoulareas, MD

1)       For acute agitation/violence: Haldol 5mg Ativan 2mg IM combo is fast, effective, and well-tolerated.  For the elderly consider half-dosing. For functional agitation (known psyc d/o), Geodon 20mg IM is becoming the go-to choice for psychiatrists.
2)       Know your demographics and risk factors for suicidal patients. Bedside assessment scales are predictive of need for hospitalization, NOT for risk of future self-harm so err on the side of caution

3)       Routine medical screening with Chem8, UDS, Etoh is neither cost-effective nor necessary. Decision-making for testing should be based on history, physical, meds, comorbidities, and clinical presentation.

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  1. Too bad we’re forced to do #3 by our psychiatric colleagues…..


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