Improving Quality of Emergency Care Through Integration of Mental Health.

The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed.

Dental Pathology in ECT Patients Prior to Treatment.

Dental complications during electroconvulsive therapy (ECT) are uncommon. Nevertheless, dental complications are often cited in ECT-related malpractice litigation. Choice of dental protection during ECT should be based on dental pathology prior to ECT.

ECT in a State Hospital Setting.

The use of electroconvulsive therapy (ECT) in U.S. state hospitals has markedly decreased in the past 20 years.

Effects of Labetalol on Hemodynamics and Seizure Duration During ECT.

Beta blockers are commonly used to attenuate the transient increase in heart rate (HR) and blood pressure (BP) that accompany electroconvulsive therapy (ECT). Recent reports have suggested that several beta blockers have anticonvulsant properties and hence could be countertherapeutic with ECT. In a randomized, double-blind controlled study of the dose response effects of intravenous labetalol on ECT hemodynamics and seizure duration, labetalol exhibited dose-dependent reduction in HR and rate pressure product (RPP) at the 5 and 10 mg doses compared to placebo.