Sunday 8 October, 2006

Dealing with borderline personality disorder

Posted in Emergency Dept., General Practice, In The Field, May Su, Psychiatry at 21:31 by May Su

Original article: May Su :: Printer friendly

There is the hypothesis that borderline personality disorder may not be a true personality disorders but rather a form of post traumatic stress disorder. Regardless, a person with borderline personality disorder will present with particular characteristic traits which can be difficult to manage.

Borderline personality disorder

Characterized by: instability of mood, poor self-esteem and self-image, and poor impulse control (1). These mood fluctuations may occur over the space of hours or days, as opposed to the mood fluctuations that occur in bipolar affective disorder. There is often a great fear of abandonment, and higher sensitivity to rejection (or perceived rejection). This can manifest as more unstable interpersonal relationships. The term “splitting” refers to these intense by transient relationships, which can suddenly switch from idealization to contempt.

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Wednesday 14 June, 2006

Schedule 2 and other forms

Posted in Emergency Dept., General Practice, In The Field, Michael Tam, Psychiatry, Resources, Wards at 10:26 by Michael Tam

Original article by: Michael Tam

These forms are probably the ones most commonly used in acute psychiatry where a patient needs involuntary assessment or treatment. They are specific for New South Wales, Australia, only under the Mental Health Act (1990).

Click here for more information on the NSW mental health legal system.

Resources

Schedule 2
Schedule 2 for the NSW Mental Health Act 1990. Allows for transport of the patient to a gazetted unit for review by a psychiatrist. Part 2 of the schedule must be completed for assistance from police.
Form 1
Form 1 for the NSW Mental Health Act 1990. Must be given to an involuntary patient and it outlines their rights under the Mental Health Act.
Form 2
Form 2 for the NSW Mental Health Act 1990. Must be completed by at least two people, one a psychiatrist to hold a patient involuntarily.

Sunday 11 June, 2006

Fluid resuscitation

Posted in Emergency, Emergency Dept., In The Field, Michael Tam, Paediatrics, Wards at 21:55 by Michael Tam

Index: Intravenous fluid therapy :: Printer friendly

Original article by: Michael Tam

There is only “one” rule for both adults and children:

Normal saline :: 10-20 mL/kg bolus :: fast as you can

If someone is shocked and requires emergency fluid resucitation, your fluid of choice is 0.9% NaCl or “normal saline”. Don’t fluff around with colloids or Hartmann’s solution – choose bog standard saline.

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