Pediatric emergency medicine trisk 4202 4202
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (99.64 KB, 1 trang )
symptoms are placed within the greater clinical context of the patient’s
presentation.
TABLE 126.27
ACUTE SCHIZOPHRENIA IN ADOLESCENCE: MOST COMMON
FEATURES
Flat affect
(Patient uninvolved and without emotion)
Auditory hallucinations
(Physician: “Have you been hearing voices even when no one is there?”)
Thoughts spoken aloud
(Physician: “Can other people read your mind? Can you read their
minds?”)
Delusions of external control
(Physician: “Is anyone trying to kill you?… trying to control your mind or
your body?”)
Management
Psychosis due to a Medical Condition. Any child with psychosis in which an
underlying medical condition is suspected requires medical admission for
diagnostic evaluation and treatment. Other important management involves
controlling the child’s behavior, preventing injury to self/others, and
alleviating the child’s fear and anxiety. This should be attempted first with
supportive statements acknowledging the child’s condition and distress, and
using distractions that allow the child to have some control, such as offering
choices of food or drink or safe toys. As the child is distractible and anxious,
instructions may need to be repeated frequently.
Brief Psychotic Episode. When a brief psychotic episode is suspected, the
emergency physician should appreciate that these children may not progress
to have a permanent psychiatric disorder. The emergency management is
similar to that of other psychotic states, including psychiatric consultation.
