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About bluemoon

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  1. I am intrested
  2. Thanks Afterlife.I passed history taking one but failed linked one
  3. Thanks Rajdeep That exactly what I did in depressive stupor and delusion of poverty one In AOT father ,s concern was telephone call from from over the weekend I fail t understand why I failed those stations
  4. can some one done exam on Thursday and passed stations Depressive stupor management AOT discussion with father Delusion of poverty station please share their experience how they approached these stations.I thought I did well but I failed those stations
  5. thanks
  6. what is your score afterlife
  7. can you give some information and if you have any study material.can you share
  8. thanks
  10. possible scenario is that pt with treatment resistant schizophrenia recently started on clozapine,developed neutropenia,father angry and asking why you did not informed me about this side effect before starting my on on this medicine what to answer pt with akathesia after taking haloperidol now demanding valium in A&E ,no history of opioid dependence ,task is to discuss management, ?can we give him valium for akathesia
  11. I think it is ward staff or ward manager who will inform the police I think first we need to use least restrictive method,try increasing observation level first and if does not work then consider seclusion yes you are right we can definitely review medication but if ward manager insist increasing\adding medication then you should say at this point but we can review his medications.Forensic assessment for the pt if history of violence
  12. please feel free to comment.add or suggest and also please discuss possible questions asked by ward manager and how to answer them Mangement plan with ward manager First of all I would introduce myself and acknowledge that there was a serious incident on ward where one of staff member was assaulted .I understand this is difficult for you and staff as it would be helpful if you can tell me what is your understanding of what happened as It will help us to formulate a joint management plan and we would be able to discuss how best we will be able to contain situation while maintaining the safety of others and also ask about member of saff who is assaulted how is he/she and I understand that you must have followed the necessary protocol and informed the police. Can you tell me what happened. Then tell the summary of my assessement ,including MSE and Risk assessment My management plan is 1-IF PT IS PSYCHOTIC AND SEVERLY AGITATED Our aim is to maintain the safety of other patients and staff on ward.As he is quite agitated and because of current risk I would suggest him transferring to PICU and close monitoring and making staff aware of the risk and to take behavioural approach in dealing with his anger, -First I would suggest using non drug approach to calm him like talking to him,talking calmly and avoid confrontation and would ask him hat he want and meet their needs as by doing that he will have a feeling that he is been heard but at the same time make sure the person who is talking to him protect himself by talking from distance,take panic alaram with him etc -If non drug approach does not contain the situation then consider use of medication to calm him down ,Use RT according to local policies and guidelines ,but make sure if pt is given RT monitor his physical state including BP,Resp ,pulse and signs of neurological reaction eg acute dystonia .Rt will help him to calm down and will reduce the risk of self harm or harm to others. -If vioelence is serious consider informing police -There should be clear documentation in medical and nursing notes -Medical and nursing staf should have a feedback session following emergency restraint and sedation.I would make sure that need for emotiona support of the staff member is validated/normalised and met.taff should have an opportunity to brief and reflect on the incidence to establish what worked well and what did not -Good practice guidelines suggest community meetings to reassure patients -I would suggest once things become better conside providing one to one time to avoid frustration to pt and provide opportunities for more activities including time out from the ward ,games and occupational therapy. -Though pt has mental illness he has the responsibility for his action.Once he is fit to be interviewed by police and you should let staff member let press the charges so that pt is aware that such aggression would not be tolerated -There is no place for adding /increasing medication at this point but we can consider involving forensic specialist for assessment 2-IF THERE IS ANY EVIDENCE OF PHYSICAL DISORDER/DELERIUM Follow management of delirium Transfer to medical ward so that pt can have access to active medical management It is important to consider use of sedation too allow a proper examination of pt 3-IF NO EVIDENCE OF ANY PSYCHOTIC /PHYSICAL DISORDER If pt,s behaviour is dangerous \seriously irresponsible inform security or call police to remove him from the premesis. If he has caused damaged to staff /propert they should be cahrged
  13. if station come as risk assessment only then what to cover
  14. it was on 12th sep
  15. yes it seem like.Can someone who passed this station share your experience