The Roles and Limitations of Psychiatric Department without Beds at General Hospital in Emergency Cases. Retrospective Investigation of Consultation-Liaison Services in Intensive Care Unit(ICU).
10.2185/jjrm.50.625
- VernacularTitle:救急医療における精神科病棟を持たない総合病院精神科の役割と限界 集中治療室新設後１年間の精神科コンサルテーション活動調査から
- Author:
Hiroaki IZUMI
;
Ichiro YANAI
- Publication Type:Journal Article
- From:Journal of the Japanese Association of Rural Medicine
2001;50(4):625-631
- CountryJapan
- Language:Japanese
-
Abstract:
JA Hiroshima General Hospital has 578 beds, and the Psychiatric Department, founded in 1994, is staffed with two doctors without beds. On June 1, 1999, the Intensive Care Unit (ICU) was newly established in the hospital. Forty-two inpatients in the ICU were referred to us during the one-year period following the establishment of the ICU in our hospital. We investigated the reasons for consultation, somatic and psychiatric diagnoses, and outcome, and compared our findings with the results of the surveys conducted by other hospitals with psychiatric units. Our investigation revealed that “suicide attempt or suicidal ideation” was highest on the list of reasons for consultation, “acute drug intoxication” was highest on the list of medical diagnoses, “adjustment disorder” was highest on the list of psychiatric diagnoses, and that “discharged from ICU” was highest of outcomes. Compared with other reports, we had small percentages of “treatment for combined medical and psychiatric illness” among the reasons for consultation, and “schizophrenia” among psychiatric diagnoses, while we had higher percentages of “adjustment disorder” among psychiatric diagnoses, and “being transferred from the ICU to a medical ward” among outcomes, In view of the riskmanagement program at the hospital, we often felt there is difficulty treating physical diseases in psychiatric patients, especially patients who have made suicide attempts in medical wards. Therefore, we consider triage may be one of the most important functions of a psychiatic department without beds. To coordinate our roles successfully, it is necessary to build an effective network with other psychiatric institutions.
