[Characteristics of psychiatric patients in the accident and emergency department (ED)]. / Charakteristik psychiatrischer Patienten in der Notaufnahme.

OBJECTIVE: To obtain data and results concerning the acute treatment of psychiatric patients within a general ED. METHODS: Retrospective examination of psychiatric cases treated in the ED of the Hannover Medical School in the year 2002. Patient characteristics were evaluated concerning diagnosis, technical examinations, therapeutic steps and data relating to the length of stay and patterns of usage of emergency services. RESULTS: 2069 psychiatric patients were seen in the ED. Additionally 563 psychiatric consultations were requested. Accordingly, psychiatry is the fourth most frequented discipline within the ED. 51.6 % of the patients were male, the average age was 43.5 years. Acute alcohol intoxication was the most frequent diagnosis with 20.2 %, followed by paranoid schizophrenia in 14.2 % and acute adjustment disorder in 6.7 % of the patients. Suicidal behaviour was present in 12.1 %. CONCLUSIONS: Psychiatric patients represent a large part of the general interdisciplinary ED. Data may support quality assurance and service planning.

Psychiatric patients turnaround times in the emergency department.

BACKGROUND: To analyze the turnaround times of psychiatric patients within the Emergency Department (ED) from registration to discharge or hospitalization in a University Hospital in 2002. METHODS: Data from a one-year period of psychiatric admissions to the emergency service at a University Hospital were monitored and analyzed focused on turnaround times within the ED. Information on patients variables such as age, sex, diagnosis, consultations and diagnostic procedures were extracted from the patients' charts. RESULTS: From 34.058 patients seen in the ED in 2002, 2632 patients were examined by psychiatrists on duty. Mean turnaround time in the ED was 123 (SD 97) minutes (median 95). Patients to be hospitalized on a psychiatric ward stayed shorter within the ED, patients who later were admitted to another faculty, were treated longer in the ED. Patients with cognitive or substance related disorders stayed longer in the ED than patients with other psychiatric diagnoses. The number of diagnostic procedures and consultations increased the treatment time significantly. CONCLUSION: As the number of patients within the examined ED increases every year, the relevant variables responsible for longer or complicated treatments were assessed in order to appropriately change routine procedures without loss of medical standards. Using this basic data, comparisons with the following years and other hospitals will help to define where the benchmark of turnaround times for psychiatric emergency services might be.