1. EMERGENCY PSYCHIATRY - MEDICAL COMPETENCY THE PSYCHIATRIC CONSULTATION

2. EMERGENCY PSYCHIATRY STANDARD OF CARE ALWAYS SAME STANDARD ALWAYS SAME STANDARD LAW ACKNOWLEDGES: LAW ACKNOWLEDGES: EMERGENT CIRCUMSTANCES EMERGENT CIRCUMSTANCES REQUIRES REASONABLE EFFORTS REQUIRES REASONABLE EFFORTS NEED TO ACT BEFORE ALL FACTS IN NEED TO ACT BEFORE ALL FACTS IN RISK KNOWN REQUIRES PLAN RISK KNOWN REQUIRES PLAN PLAN REQUIRES ACTION PLAN REQUIRES ACTION

3. DECISIONS IS PATIENT PSYCHIATRIC? IS PATIENT PSYCHIATRIC? WHAT DO YOU NEED TO KNOW? WHAT DO YOU NEED TO KNOW? WHO KNOWS IT? WHO KNOWS IT? DOES PATIENT NEED HOSPITALIZATION? DOES PATIENT NEED HOSPITALIZATION? VOLUNTARY OR INVOLUNTARY? VOLUNTARY OR INVOLUNTARY? IF YOU DECIDE NOT TO ADMIT: IF YOU DECIDE NOT TO ADMIT: DOES PATIENT HAVE COMMUNITY SUPPORT? DOES PATIENT HAVE COMMUNITY SUPPORT? WILL PATIENT BE SAFE UNTIL FOLLOW-UP? WILL PATIENT BE SAFE UNTIL FOLLOW-UP? DO YOU HAVE REPORTING DUTY? DO YOU HAVE REPORTING DUTY?

4. CHARTING CHART LESSER INTERVENTION MORE THAN GREATER ONE CHART LESSER INTERVENTION MORE THAN GREATER ONE DO YOU NOW 6-O’CLOCK NEWS RULE DO YOU NOW 6-O’CLOCK NEWS RULE LAW SAYS NOT CHARTED, NOT DONE LAW SAYS NOT CHARTED, NOT DONE ALWAYS COMMENT ON COMPETENCY ALWAYS COMMENT ON COMPETENCY TIME YOUR NOTE TIME YOUR NOTE

5. MEDICAL COMPETENCY PSYCHIATRIC CONSULTATION COMPETENCY PRESUMED IN EMERGENCY COMPETENCY PRESUMED IN EMERGENCY IF NOT EMERGENCY, “ESTABLISHED CUSTOM”? IF NOT EMERGENCY, “ESTABLISHED CUSTOM”? LPS DOES NOT AUTHORIZE MEDICAL RX LPS DOES NOT AUTHORIZE MEDICAL RX A PATIENT REFUSAL IS INCOMPETENT IF: A PATIENT REFUSAL IS INCOMPETENT IF: UNABLE TO RESPOND KNOWINGLY AND INTELLIGENTLY TO QUESTIONS ABOUT RX UNABLE TO RESPOND KNOWINGLY AND INTELLIGENTLY TO QUESTIONS ABOUT RX UNABLE TO PARTICIPATE IN TREATMENT DECISIONS USING RATIONAL PROCESSES UNABLE TO PARTICIPATE IN TREATMENT DECISIONS USING RATIONAL PROCESSES UNABLE TO UNDERSTAND INFORMATION ABOUT THE RECOMMENDED TREATMENT UNABLE TO UNDERSTAND INFORMATION ABOUT THE RECOMMENDED TREATMENT

6. THE PSYCHIATRIC CONSULTATION IF REFUSING, PT MUST BE TOLD ALL RISKS IF REFUSING, PT MUST BE TOLD ALL RISKS DO GOOD MSE (PROBATE 811) DO GOOD MSE (PROBATE 811) DETERMINE FOLLOWING: DETERMINE FOLLOWING: DID PATIENT COMMUNICATE DECISION? DID PATIENT COMMUNICATE DECISION? WAS DECISION BASED ON CONSENT INFORMATION? WAS DECISION BASED ON CONSENT INFORMATION? IS THERE MENTAL STATUS DEFECT? IS THERE MENTAL STATUS DEFECT? DOES THE DEFECT EXPLAIN THE REFUSAL? DOES THE DEFECT EXPLAIN THE REFUSAL? WRITE NOTE SUFFICIENT FOR PETITIION WRITE NOTE SUFFICIENT FOR PETITIION IF INCOMPETENT, BURDEN ON PCP TO ACT. IF INCOMPETENT, BURDEN ON PCP TO ACT.

7. SHC ETHICS POLICY GUIDELINES INFORMED CONSENT WHEN ADULT PATIENT LACKS CAPACITY IF PATIENT HAS APPOINTED SURROGATE IF PATIENT HAS APPOINTED SURROGATE IF PATIENT HAS NO APPOINTED SURROGATE IF PATIENT HAS NO APPOINTED SURROGATE