Additional Information
Book Details
Abstract
Ideal for any on-call professional, resident, or medical student, this best-selling reference by Drs. Carol A. Bernstein, Molly E. Poag, and Mort Rubinstein covers the common problems you’ll encounter while on call without direct supervision in the hospital. On Call Psychiatry, 4th Edition, fits perfectly in your pocket, ready to provide key information in time-sensitive, challenging situations. You’ll gain speed, skill, and knowledge with every call - from diagnosing a difficult or life-threatening situation to prescribing the right medication.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Inside Front Cover | ES2 | ||
| On Call Psychiatry | iii | ||
| Copyright | iv | ||
| Preface | v | ||
| Foreword | vii | ||
| Acknowledgments | ix | ||
| Contributors | xi | ||
| Structure of the Book | xv | ||
| Phone call | xv | ||
| Questions | xv | ||
| Orders | xv | ||
| Inform RN | xv | ||
| Elevator thoughts | xv | ||
| Major Threat to Life | xv | ||
| Bedside | xvi | ||
| Quick Look Test | xvi | ||
| Management | xvi | ||
| Contents | xvii | ||
| Chapter 1: Approach to Emergency Psychiatric Evaluation | 1 | ||
| Triage | 2 | ||
| Agitation/Alertness | 2 | ||
| Beware of masquerading medical conditions | 2 | ||
| Consider a wide differential of psychiatric diagnoses | 3 | ||
| Patient Interview | 4 | ||
| Collateral Information | 4 | ||
| Documentation | 4 | ||
| Final Thoughts | 4 | ||
| Suggested Readings | 5 | ||
| Chapter 2: The Role of the On-Call Psychiatric Consultant | 6 | ||
| Being an Effective Consultant | 6 | ||
| Reasons for Consultation | 7 | ||
| Psychiatric disorders manifesting as management problems | 7 | ||
| Psychiatric disorders due to medical conditions | 7 | ||
| Substance-related disorders | 7 | ||
| Psychopharmacologic management | 8 | ||
| Other psychiatric disorders | 8 | ||
| Psychiatric disorders related to adjustment to medical conditions | 8 | ||
| Psychiatric disorders manifesting as medical conditions | 8 | ||
| How to Complete a Consult | 8 | ||
| Phone call | 8 | ||
| Questions | 8 | ||
| Orders | 9 | ||
| Collecting Data | 9 | ||
| Chart review | 9 | ||
| Information from the treatment team | 10 | ||
| Other sources of information | 10 | ||
| Major Threat to Life | 10 | ||
| Bedside | 11 | ||
| Quick-Look Test | 11 | ||
| Establishing Rapport | 11 | ||
| The Interview | 11 | ||
| Consult Note | 11 | ||
| History of present illness | 12 | ||
| Assessment | 12 | ||
| Recommendations | 12 | ||
| Communicating With the Treatment Team | 13 | ||
| Follow-Up | 13 | ||
| Suggested Readings | 13 | ||
| Chapter 3: Psychodynamic Issues | 14 | ||
| General Principles | 14 | ||
| Clinical Examples | 16 | ||
| Transference | 16 | ||
| Countertransference | 16 | ||
| Denial | 17 | ||
| Projection and projective identification | 18 | ||
| Splitting | 19 | ||
| Somatization | 19 | ||
| Help-rejecting complaining | 20 | ||
| Conclusion | 21 | ||
| Suggested Readings | 21 | ||
| Chapter 4: Telephone Consultations | 22 | ||
| Psychiatric Consultations for Hospitalized Patients | 22 | ||
| Outside Calls | 24 | ||
| Chapter 5: Seclusion and Restraint | 27 | ||
| General Principles | 27 | ||
| Literature Review | 27 | ||
| Definitions | 28 | ||
| Indications and Contraindications | 29 | ||
| Indications | 29 | ||
| Contraindications | 29 | ||
| Special Considerations | 30 | ||
| Developmental disabilities | 30 | ||
| Children | 30 | ||
| Victims of abuse | 30 | ||
| Delirious patients | 30 | ||
| Elderly patients | 31 | ||
| Patients with significant medical conditions | 31 | ||
| Physician Response | 31 | ||
| Procedure for Locked Seclusion and Restraint | 31 | ||
| Team | 32 | ||
| Logistics | 32 | ||
| Approach | 33 | ||
| Implementation | 33 | ||
| Debriefing | 34 | ||
| Patient | 34 | ||
| Documentation | 35 | ||
| Hospital forms | 35 | ||
| Note | 35 | ||
| Electronic or written order | 36 | ||
| Continuation and Discontinuation of Restrictions | 36 | ||
| Safety Warnings | 36 | ||
| Suggested Readings | 37 | ||
| Chapter 6: Assessment of Capacity and Other Legal Issues | 38 | ||
| Capacity and Competency | 38 | ||
| Capacity criteria | 39 | ||
| Informed consent | 40 | ||
| Capacity consults: treatment refusal and acceptance | 41 | ||
| Questions for the team | 41 | ||
| Evaluating the patient | 42 | ||
| Communicating the assessment | 43 | ||
| Psychiatric Admission, Treatment, and Discharge | 44 | ||
| Admission | 44 | ||
| Involuntary treatment | 46 | ||
| Discharge | 46 | ||
| Confidentiality | 47 | ||
| Suggested Readings | 48 | ||
| Chapter 7: The Difficult Patient | 49 | ||
| Introduction | 49 | ||
| The Consult | 49 | ||
| Elevator thoughts | 51 | ||
| Bedside | 52 | ||
| Management | 53 | ||
| Concluding Thoughts | 54 | ||
| Suggested Readings | 54 | ||
| Chapter 8: Emergency Evaluation of Children and Adolescents | 55 | ||
| Phone call | 56 | ||
| Questions | 56 | ||
| Requests for Staff Before Consultant Arrives | 56 | ||
| Elevator thoughts | 56 | ||
| Major threat to life | 57 | ||
| Safety | 57 | ||
| Suicidality | 57 | ||
| Homicidality and Aggression | 58 | ||
| Assessment | 59 | ||
| Management | 60 | ||
| Admission or Discharge | 60 | ||
| Treatment of Acute Agitation | 61 | ||
| Nonpharmacologic Management of Agitation | 62 | ||
| Pharmacologic Management of Agitation | 62 | ||
| Antihistamines | 62 | ||
| Diphenhydramine (Benadryl) | 62 | ||
| Benzodiazepines | 63 | ||
| Lorazepam (Ativan) | 63 | ||
| First-Generation Antipsychotics | 63 | ||
| Haloperidol (Haldol) | 63 | ||
| Chlorpromazine (Thorazine) | 63 | ||
| Second-Generation Antipsychotics | 63 | ||
| Risperidone (Risperdal) | 63 | ||
| Olanzapine (Zyprexa) | 64 | ||
| Suggested Readings | 64 | ||
| Chapter 9: The Agitated Patient | 65 | ||
| Phone Call | 65 | ||
| Questions | 65 | ||
| Orders | 66 | ||
| Inform RN | 66 | ||
| Elevator thoughts | 67 | ||
| Psychiatric Causes of Agitation | 67 | ||
| Substance Use Disorders (See Later) | 68 | ||
| Medical Causes of Agitation | 68 | ||
| Major threat to life | 69 | ||
| Bedside | 70 | ||
| Quick-Look Test | 70 | ||
| Management | 71 | ||
| Medical Interventions | 71 | ||
| Verbal Deescalation and Reorientation | 71 | ||
| Environmental Modifications | 71 | ||
| Oral Medications | 71 | ||
| Intramuscular Medications (i.e., Chemical Restraint) | 72 | ||
| Physical Restraints | 72 | ||
| Continued Management | 72 | ||
| Medicating the patient | 73 | ||
| Suggested Readings | 74 | ||
| Chapter 10: The Anxious Patient | 76 | ||
| Phone call | 76 | ||
| Questions | 76 | ||
| Orders | 77 | ||
| Inform RN | 77 | ||
| Elevator thoughts | 77 | ||
| Major threat to life | 79 | ||
| Bedside | 80 | ||
| Quick Look Test | 80 | ||
| Airway and Vital Signs | 80 | ||
| Selective History and Chart Review | 80 | ||
| Mental Status Examination | 82 | ||
| Selective Physical Examination | 83 | ||
| Management | 83 | ||
| Chapter 11: The Violent Patient | 88 | ||
| Phone call | 88 | ||
| Questions | 88 | ||
| Orders | 89 | ||
| Inform RN | 89 | ||
| Elevator thoughts | 89 | ||
| Bedside | 90 | ||
| Chart Review | 90 | ||
| Quick Look Test | 90 | ||
| Vital Signs | 91 | ||
| Approaching the Patient | 91 | ||
| Selective History and Mental Status | 92 | ||
| Initial management | 92 | ||
| Safety and Tolerability Issues | 94 | ||
| Physical Restraints | 95 | ||
| Next steps in management | 95 | ||
| Remember | 97 | ||
| Suggested Readings | 97 | ||
| Chapter 12: The Suicidal Patient | 98 | ||
| The Consult | 98 | ||
| Phone call | 98 | ||
| Questions | 98 | ||
| Orders | 99 | ||
| Inform RN | 100 | ||
| Elevator thoughts | 100 | ||
| Bedside | 101 | ||
| Interview | 102 | ||
| Technique | 102 | ||
| Selective History | 102 | ||
| Mental Status Examination | 104 | ||
| Management | 104 | ||
| Suggested Readings | 106 | ||
| Chapter 13: The Psychotic Patient | 107 | ||
| Phone call | 107 | ||
| Questions | 107 | ||
| Orders | 108 | ||
| Inform RN | 108 | ||
| Elevator thoughts | 108 | ||
| Major threat to life | 108 | ||
| Bedside | 108 | ||
| Quick Look Test | 108 | ||
| Airway and vital signs | 112 | ||
| Selective history and chart review | 112 | ||
| Selective physical examination | 112 | ||
| Selective mental status examination | 112 | ||
| Laboratory evaluation | 113 | ||
| Management | 113 | ||
| Chapter 14: The Confused Patient: Delirium and Dementia | 115 | ||
| Definitions | 115 | ||
| Delirium | 115 | ||
| Dementia | 116 | ||
| Pseudodementia | 117 | ||
| Amnestic disorder | 117 | ||
| Phone call | 117 | ||
| Questions | 117 | ||
| Orders | 118 | ||
| Inform RN | 118 | ||
| Elevator thoughts | 118 | ||
| Delirium | 118 | ||
| Dementia | 119 | ||
| Differential diagnoses | 119 | ||
| Pseudodementia | 119 | ||
| Amnestic Disorder | 120 | ||
| Life-Threatening Causes Leading to Delirium | 120 | ||
| Remember | 120 | ||
| Bedside | 120 | ||
| Quick Look Test | 120 | ||
| Airway and vital signs | 120 | ||
| Selective history and chart review | 121 | ||
| Selective physical examination | 121 | ||
| Delirium | 121 | ||
| Selective mental status examination | 121 | ||
| Laboratory tests | 122 | ||
| Management | 122 | ||
| Structured Environment | 122 | ||
| Treatment of the Underlying Medical Disorder | 123 | ||
| Medication-Related Delirium | 123 | ||
| Other Underlying Problems | 123 | ||
| Medications to Treat the Underlying Disorder | 123 | ||
| Calming the Delirious Patient | 123 | ||
| Dementia | 124 | ||
| Selective mental status examination | 124 | ||
| Laboratory tests | 125 | ||
| Management | 125 | ||
| Treatment of the Underlying Medical Disorder | 125 | ||
| Medications | 126 | ||
| Physical Restraints | 127 | ||
| Amnesia | 127 | ||
| Selective mental status examination | 127 | ||
| Management | 127 | ||
| Suggested Readings | 127 | ||
| Chapter 15: Movement Disorders | 129 | ||
| Phone call | 129 | ||
| Questions | 129 | ||
| Orders | 130 | ||
| Inform RN | 130 | ||
| Elevator thoughts | 130 | ||
| Major threat to life | 130 | ||
| Neuroleptic Malignant Syndrome | 130 | ||
| Laryngeal dystonia | 135 | ||
| Acute Stroke | 135 | ||
| Bedside | 135 | ||
| Quick Look Test | 135 | ||
| Airway and Vital Signs | 136 | ||
| Selective Neurologic Examination | 136 | ||
| Management | 137 | ||
| Neuroleptic Malignant Syndrome | 137 | ||
| Acute Dystonia | 137 | ||
| Remember | 138 | ||
| Suggested Readings | 138 | ||
| Chapter 16: Barriers to Communication: Mutism and Other Problems With Speech and Communication | 139 | ||
| Phone call | 139 | ||
| Questions | 139 | ||
| Orders | 140 | ||
| Inform RN | 140 | ||
| Elevator thoughts | 140 | ||
| Major threat to life | 141 | ||
| Bedside | 141 | ||
| Quick Look Test | 141 | ||
| Selective History and Chart Review | 142 | ||
| Assessment of Speech and Communication | 145 | ||
| Selective Neurologic Examination | 145 | ||
| General Appearance | 145 | ||
| Face and Eyes | 148 | ||
| Extremities | 148 | ||
| Diagnostic Tests | 148 | ||
| Neuroimaging | 148 | ||
| Laboratory Studies | 149 | ||
| Electroencephalography | 149 | ||
| Additional Diagnostic Techniques | 149 | ||
| Management | 149 | ||
| General Guidelines for Dealing With Mutism of a Psychiatric Etiology | 150 | ||
| Additional Considerations in Catatonia | 151 | ||
| Chapter 17: Physical and Sexual Trauma | 152 | ||
| Background | 152 | ||
| Phone call | 152 | ||
| Questions | 152 | ||
| Orders | 153 | ||
| Inform RN | 153 | ||
| Elevator thoughts | 153 | ||
| Major threat to life | 154 | ||
| Bedside | 154 | ||
| Quick-Look Test | 154 | ||
| Airway and Vital Signs | 154 | ||
| Selective History | 154 | ||
| Selective Physical Examination | 156 | ||
| Management | 156 | ||
| Special considerations for other populations | 157 | ||
| Child Abuse | 157 | ||
| Intimate Partner Violence | 158 | ||
| Elder Abuse | 158 | ||
| Survivors of Disasters | 159 | ||
| Suggested Readings | 159 | ||
| Chapter 18: The Pregnant Patient | 161 | ||
| Phone call | 161 | ||
| Questions | 161 | ||
| Chart Review | 162 | ||
| Orders | 162 | ||
| Inform Consulting Staff | 162 | ||
| Elevator thoughts | 163 | ||
| Liaison: Dealing With Heightened Anxiety in Team Members | 163 | ||
| Causes of Delirium/Agitation in Pregnancy | 163 | ||
| Bedside | 163 | ||
| Quick Look Test | 163 | ||
| Major threat to life | 164 | ||
| Suicide | 164 | ||
| Violence/Aggression Due to Psychosis, Lack of Behavioral Control | 164 | ||
| Infanticide | 165 | ||
| Postpartum Psychosis | 165 | ||
| Alcohol Withdrawal in Pregnancy | 166 | ||
| Management | 167 | ||
| First Trimester | 167 | ||
| Second Trimester | 168 | ||
| Third Trimester and Labor | 168 | ||
| Medications in Pregnancy | 168 | ||
| Neuroleptics | 169 | ||
| Mood Stabilizers | 169 | ||
| Antidepressants | 169 | ||
| Anxiolytics | 170 | ||
| Suggested Readings | 170 | ||
| Chapter 19: Intoxication | 172 | ||
| Phone call | 172 | ||
| Questions | 172 | ||
| Orders | 172 | ||
| Inform RN | 172 | ||
| Elevator thoughts | 173 | ||
| Bedside | 173 | ||
| Quick Look Test | 173 | ||
| Vital Signs | 174 | ||
| Selective History | 174 | ||
| Selective Physical Examination | 174 | ||
| Substance-specific intoxication syndromes | 174 | ||
| Alcohol | 174 | ||
| Serious Alcohol Intoxication | 175 | ||
| Psychostimulants (Cocaine, Amphetamines) | 175 | ||
| Marijuana (Cannabis) and Synthetic Cannabinoid Receptor Agonists (K2 and Spice) | 176 | ||
| Opioids | 177 | ||
| Hallucinogens | 178 | ||
| Phencyclidine and Ketamine | 179 | ||
| Sedative-Hypnotics | 179 | ||
| Inhalants | 180 | ||
| Club Drugs: Methylenedioxymethamphetamine, Gamma Hydroxybutyrate, Ketamine | 181 | ||
| Methylenedioxymethamphetamine/``Ecstasy´´ | 181 | ||
| Gamma-Hydroxybutyrate | 181 | ||
| Anticholinergic Drugs | 182 | ||
| Selective Serotonin Reuptake Inhibitors | 183 | ||
| Caffeine | 183 | ||
| Suggested Readings | 184 | ||
| Chapter 20: Substance Withdrawal | 185 | ||
| Phone call | 185 | ||
| Questions | 185 | ||
| Orders | 186 | ||
| Inform RN | 186 | ||
| Elevator thoughts | 186 | ||
| Substance-Specific Syndromes | 186 | ||
| Initial assessment | 187 | ||
| History/Chart Review | 187 | ||
| Specific withdrawal conditions | 188 | ||
| Alcohol Withdrawal | 188 | ||
| Signs and Symptoms | 188 | ||
| Immediate Steps | 189 | ||
| Management of Seizures | 190 | ||
| Management of Withdrawal Delirium | 190 | ||
| Other Complications | 191 | ||
| Sedative/Hypnotic/Anxiolytic Withdrawal | 191 | ||
| Immediate Steps | 192 | ||
| Opiate Withdrawal | 193 | ||
| Signs and Symptoms | 193 | ||
| Immediate Steps | 193 | ||
| Medications | 194 | ||
| Other Complications | 195 | ||
| Central Nervous System Stimulants (Cocaine and Amphetamines) | 195 | ||
| Immediate Steps | 196 | ||
| Medication | 196 | ||
| Club Drugs: Methylenedioxymethamphetamine (``Ecstasy´´) and Gamma-Hydroxybutyrate | 196 | ||
| Methylenedioxymethamphetamine Withdrawal | 196 | ||
| Signs and symptoms | 196 | ||
| Gamma-Hydroxybutyrate Withdrawal | 197 | ||
| Chapter 21: Insomnia | 202 | ||
| Phone call | 202 | ||
| Questions | 202 | ||
| Orders | 203 | ||
| Inform RN | 203 | ||
| Remember | 203 | ||
| Elevator thoughts | 203 | ||
| Major threats to life | 205 | ||
| Bedside | 205 | ||
| Quick Look Test | 205 | ||
| Selective Chart Review | 206 | ||
| Selective History | 206 | ||
| Common causes of insomnia | 207 | ||
| Medical Problems | 207 | ||
| Psychiatric Disorders | 208 | ||
| Primary Sleep Disorders | 208 | ||
| Poor Sleep Hygiene | 209 | ||
| Management | 209 | ||
| Chapter 22: Headache | 211 | ||
| Phone call | 211 | ||
| Questions | 211 | ||
| Orders | 212 | ||
| Inform RN | 212 | ||
| Elevator thoughts | 212 | ||
| Major threat to life | 213 | ||
| Bedside | 214 | ||
| Quick Look Test | 214 | ||
| Vital Signs | 214 | ||
| Selective History and Chart Review | 215 | ||
| Selective Physical Examination | 217 | ||
| Management | 218 | ||
| Serious Conditions | 218 | ||
| Less Serious Conditions | 219 | ||
| Suggested Readings | 220 | ||
| Chapter 23: Chest Pain | 221 | ||
| Phone call | 221 | ||
| Questions | 221 | ||
| Orders | 221 | ||
| Inform RN | 222 | ||
| Elevator thoughts | 222 | ||
| Life-threatening causes | 223 | ||
| Bedside | 223 | ||
| Quick Look Test | 223 | ||
| Airway and Vital Signs | 224 | ||
| Mental Status Examination | 224 | ||
| Selective History and Chart Review | 225 | ||
| Selective Physical Examination | 225 | ||
| Management | 226 | ||
| Suggested Readings | 227 | ||
| Chapter 24: Nausea and Vomiting | 228 | ||
| Background | 228 | ||
| Physiology | 228 | ||
| Presentation and differential diagnosis | 229 | ||
| Phone call | 231 | ||
| Questions | 231 | ||
| Orders | 231 | ||
| Inform RN | 232 | ||
| Elevator thoughts | 232 | ||
| Management | 232 | ||
| Suggested Readings | 234 | ||
| Chapter 25: Fever | 235 | ||
| Phone call | 235 | ||
| Questions | 235 | ||
| Orders | 236 | ||
| Inform RN | 236 | ||
| Elevator thoughts | 236 | ||
| Major threat to life | 237 | ||
| Bedside | 237 | ||
| Quick Look Test | 237 | ||
| Airway, Breathing, Circulation, and Vital Signs | 237 | ||
| Selective Physical Examination I | 238 | ||
| Management | 239 | ||
| Initial Management | 239 | ||
| Selective Chart Review | 241 | ||
| Selective Physical Examination II | 241 | ||
| Subsequent Management | 242 | ||
| Remember | 243 | ||
| Chapter 26: Seizures | 244 | ||
| Phone call | 244 | ||
| Questions | 244 | ||
| Orders | 245 | ||
| Inform RN | 249 | ||
| Elevator thoughts | 249 | ||
| Urgent Issues to Consider | 250 | ||
| What Kind of Seizure Was It? | 250 | ||
| What Caused the Seizure? (Useful Mnemonic-VITAMINNS) | 251 | ||
| V. Vascular | 251 | ||
| I. Infectious | 251 | ||
| T. Trauma | 251 | ||
| A. Autoimmune | 252 | ||
| M. Metabolic/Toxic | 252 | ||
| I. Idiopathic/Iatrogenic | 252 | ||
| N. Neoplastic | 252 | ||
| N. Nutritional | 252 | ||
| S. Structural/Congenital | 252 | ||
| Management | 252 | ||
| Principles of Seizure Management | 252 | ||
| Status Epilepticus: A Medical Emergency | 253 | ||
| Seizure Precautions | 253 | ||
| Suggested Readings | 254 | ||
| Chapter 27: Falls | 255 | ||
| Phone call | 255 | ||
| Questions | 255 | ||
| Orders | 256 | ||
| Priorities | 256 | ||
| Elevator thoughts | 256 | ||
| Medical and neurologic emergencies | 257 | ||
| Bedside | 257 | ||
| Quick Look Test | 257 | ||
| Airway and Vital Signs | 257 | ||
| Orthostasis | 257 | ||
| Selective History | 258 | ||
| Selective Physical Examination | 258 | ||
| Selective Chart Review | 259 | ||
| Management | 259 | ||
| Provisional Diagnosis | 259 | ||
| Complications | 259 | ||
| Treat the cause | 259 | ||
| Suggested Readings | 260 | ||
| Chapter 28: Blood Pressure Changes | 261 | ||
| Phone call | 261 | ||
| Questions | 261 | ||
| Orders | 261 | ||
| Inform RN | 261 | ||
| Elevator thoughts | 262 | ||
| Major threat to life | 262 | ||
| Bedside | 263 | ||
| Quick Look Test | 263 | ||
| Airway and Vital Signs | 263 | ||
| Chart Review | 263 | ||
| Selective History | 263 | ||
| Selective Physical Examination | 264 | ||
| Management | 264 | ||
| Neuroleptic Malignant Syndrome and Serotonin Syndrome | 264 | ||
| Hypertension | 264 | ||
| Hypotension | 265 | ||
| Remember | 266 | ||
| Suggested Readings | 266 | ||
| Chapter 29: Telepsychiatry | 267 | ||
| Before the phone call | 267 | ||
| Questions | 268 | ||
| Elevator thoughts | 268 | ||
| Phone call | 269 | ||
| Questions | 269 | ||
| Prior to Videoteleconferencing Interview and Exam | 270 | ||
| Videoteleconferencing With Patient | 270 | ||
| After videoteleconferencing interview and exam | 271 | ||
| Remember | 271 | ||
| Suggested Readings | 271 | ||
| Chapter 30: Cross-Cultural Issues | 273 | ||
| Phone call | 274 | ||
| Questions | 274 | ||
| Elevator thoughts | 274 | ||
| Bedside | 275 | ||
| Management | 276 | ||
| Further thoughts | 276 | ||
| Suggested Readings | 277 | ||
| Appendix A: MoCA | 278 | ||
| Suggested Readings | 279 | ||
| Appendix B: Mental Status Exam | 280 | ||
| Appendix C: Medical Conditions Manifesting as Psychiatric Disorders | 284 | ||
| Appendix D: Neurologic Examination | 292 | ||
| Mental Status | 292 | ||
| Cranial Nerves | 296 | ||
| Motor | 298 | ||
| Sensory | 299 | ||
| Coordination | 299 | ||
| Gait | 299 | ||
| Reflexes | 300 | ||
| Suggested Readings | 301 | ||
| Appendix E: Urine Toxicology | 302 | ||
| Appendix F: Substance Detoxification Regimens | 305 | ||
| Alcohol Detoxification Regimens | 305 | ||
| Regimen 1: Symptom-triggered therapy | 305 | ||
| Regimen 2: Fixed-dose therapy | 306 | ||
| Sedative-Hypnotic Detoxification Regimens | 306 | ||
| Regimen 1: Slow taper (outpatient) | 307 | ||
| Regimen 2: Substitution and taper | 307 | ||
| Opioid Detoxification Regimen | 307 | ||
| Regimen 1: Methadone taper | 308 | ||
| Regimen 2: Clonidine detoxification | 308 | ||
| Suggested Readings | 309 | ||
| Appendix G: Abuse and Neglect of Children and Elders | 310 | ||
| Child Abuse and Neglect | 310 | ||
| Elder Abuse and Neglect | 312 | ||
| Physical Abuse | 313 | ||
| Sexual Abuse | 313 | ||
| Emotional Abuse | 314 | ||
| Neglect | 314 | ||
| Financial Exploitation | 314 | ||
| Self-Neglect and Self-Abuse | 315 | ||
| Abandonment | 315 | ||
| If You Suspect Elder Abuse or Neglect | 315 | ||
| Suggested Readings | 316 | ||
| Index | 317 |