Reflecting on the Rotation

My psychiatry rotation consisted of being in an emergency room comprehensive psychiatric emergency program (CPEP) doing 12-hour shifts three days a week for five weeks. My shifts were during the day at 8am-8pm weekdays and also being there for a few weekends. I really enjoyed my five weeks working in CPEP seeing many different patients with many different pathologies. There were generally around 15-25 patients daily in CPEP. CPEP consisted of many different areas. There was a triaging area where new patients would come in to talk to the psychiatrist, nurses, clerks, and others who were there. From there the …

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Site Evaluation Summary

For my site evaluations, I did three History and Physicals on three different patients. The first patient I wrote about had was a woman who had aggressive and threatening behavior back at home. She was acting erratic and was brought in by her husband. The patient’s speech was hyperverbal and pressured. He said she did not sleep for 4-5 days. The first diagnosis I had on my differential was bipolar 1 disorder. The next diagnosis I had was drug-induced psychosis because the patient did admit to doing drugs like cocaine and marijuana often. The second patient I wrote about took …

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Journal Entry

Olanzapine-Samidorphan for Schizophrenia: A Systematic Review and Meta-Analysis Schizophrenia and bipolar disorder are serious mental health conditions that affect how people think, feel, and behave on the daily basis. Schizophrenia involves patients who have auditory/visual hallucinations, delusions, and disorganized thoughts and behaviors. Bipolar disorder sees patients with extreme mood swings that can include emotional highs (like in a manic phase) and lows (depression). Olanzapine is a second-generation atypical antipsychotic medication that works on the 5HT2A receptor, that aids in helping patients with schizophrenia and bipolar disorder. One of the main drawbacks to long-term Olanzapine use is that it gives rise …

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History & Physical

CC – As per patient’s husband patient was having “Aggressive and threatening behavior” X 2 hours ago HPI – 26 y/o female with history of psychosis who was brought in by EMS activated by her husband for agitation and erratic behavior. Both husband and patient have not been living in the same apartment for the past month because husband stated he needed space from his wife. Today patient’s husband came to their apartment along with patient’s father and saw the patient with another unidentified man in their living room. The husband noticed a baggy with some kind of white substance …

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Emergency Medicine – PICO #3

Brief description of patient problem/setting (summarize the case very briefly) Working in the main ER, you notice a patient getting triaged that has shortness of breath, fever, chills and fatigue. They tested negative for COVID/Flu and you are suspecting pneumonia. Standard of practice is getting a chest x-ray to confirm the diagnosis, but you have seen FAST exams being done for fluid accumulation in the chest and abdomen, and wonder if POC ultrasound can be used to look for consolidations like pneumonia in an acute situation. Search Question: Clearly state the question (including outcomes or criteria to be tracked) In …

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Emergency Medicine – PICO #2

Brief description of patient problem/setting (summarize the case very briefly) As you come into the emergency room for your shift, the other PA gives you the sign off on a patient that came in with diabetic ketoacidosis. You notice the bag of intravenous insulin that is helping offset the DKA, and you wonder if insulin given subcutaneously would also help the patient without possibly having them become hypoglycemic. Search Question: Clearly state the question (including outcomes or criteria to be tracked) In patients with diabetic ketoacidosis, how does subcutaneous insulin versus intravenous insulin affect the time to DKA resolution and …

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Emergency Medicine – PICO #1

Brief description of patient problem/setting (summarize the case very briefly) While viewing a patient come into the emergency department for a cardiac arrest, you investigate different modalities that can used to extend neurological outcomes and survival rates of affected patients before they hit the ambulance doors of the ED. One of the longer standing attending physicians talks about cooling techniques that can possibly be utilized. Search Question: Clearly state the question (including outcomes or criteria to be tracked) In adults with out-of-hospital cardiac arrest, does prehospital therapeutic hypothermia compared to standard care without prehospital hypothermia improve neurological outcomes and survival …

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