Mental health disorders account for 5.5 percent of emergency department (ED) visits, and of these visits, 21 percent are due to self-identified anxiety, said Lisa Wolf, RN, MS, CEN, in her Friday session.
The initial assessment goal for the emergency nurse is to determine whether anxiety is the primary problem or the primary symptom of another problem, said Wolf.
“In the ED we have knives coming at our heads and people bleeding, so it’s not the best environment for us to delineate what is going on with our patient,” she said.
So it is important to know what can look like anxiety. Hypoxia, hypoglycemia, hyperthyroidism, acidosis, some reactions to alcohol and certain drugs, and impending doom can all present as anxiety, said Wolf. She discussed what to look for, how to identify it and how to treat each problem.
The take-home information from this session included the importance of conducting a thorough evaluation on patients who exhibit “anxiety-plus” or have that extra dollop of pain, difficulty breathing or a funny color, said Wolf.
“We want to pay attention to these folks,” she said. “Sometimes it is just anxiety, but delineating that is crucial. Ask your patients, ‘Why are you in my ED? What is different about how you’re feeling today?’”
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