5150 holds

At any one time, what percentage of your patients are 5150 holds, psych or intoxicated?

I work in a large, city ED. At any given time, something like 20-30% of our patients are psych holds of various sorts, including the drunks and tweakers... a lot of them are BS, granted, but they take up an inordinate amount of time and attention - and are often very disruptive, and mostly likely to be found urinating and vomiting on themselves.

I get so tired of dealing with them... my eyes light up when I draw a high-acuity patient or assignment.

[ChristineN, BSN, RN]

I have never heard that term before, I am guessing it is specific to your state. I am assuming you mean involuntary holds or "FD-12's" as we call them here

[Larry77, RN]

In most states these patients shouldn't actually be on a hold until they start trying to leave. Are you guys just putting them on a hold on arrival because they are under the influence? Each state is very different in the way they process holds, hours, court etc. Fortunately the hospital I work in does not have inpatient psych so we don't see quite the volume of true psych's as other places I've worked. The drunk people do come but we don't put them on a hold unless they are attempting to elope.

[itsnowornever, BSN, RN]

5150s are usually placed in EDs by the police because they are a danger to themselves or others here, not just because they are drunk or high. My husband takes them in rarely...usually 4-5 a quarter, but he does see an increase over the summer.Usually they are in the ED for 1-4 hours before the MEU comes to see them or they are admitted. Hubby will also try to use the mobile team and have the mobile team deal with them for a direct admit from the field cutting down on the time he has to take up in the ED

[NeoPediRN]

up to 50%

[NickiLaughs, ADN, BSN, RN]

Somewhere around 20%. It's really frustrating when your paranoid schizo manages to houdini herself out of 5 pt restraints for the door when you have a fresh spleen lac...and their IV stopped working.

We are actually planning on making a 5150 hold area at my hospital completely separate from the ER, I think the plan is to have 8 or 12 beds and it will be staffed with a couple psych techs. They will have something other than 4 walls to keep them busy, and they won't be causing so much ruckus in our ER.

[emtb2rn, BSN, RN, EMT-B]

We have separate locked psych area. 5 rooms plus hallway recliners and chairs for a total of 10 possible patients. 1 rn, 1 tech, at least 1 security guard. We're the county psych receiving center so we have pscy screeners and a psychiatrist or telepsych (video link to psychiatrist) 24x7. All patients must be able to walk without assistance.

[ezgreazin]

sometimes up to 75%, hopefully 0%...some sure can suck the life out of you. I find it almost easier if they have a 5150 placed (geodon, my friend?) instead of the belligerent drunk or psych who "knows their rights, and I don't have to take/do that" blah blah blah

[turnforthenurse, MSN, NP]

We have a couple of psych rooms but there are other times where we have more patients than available psych rooms. The 5150's are held until MH or an intake nurse from our psych unit comes and sees them. It can sometimes be a very lengthy process. I've seen patients there for well over 24 hours.

[SweetMelissaRN]

We have a couple of psych rooms but there are other times where we have more patients than available psych rooms. The 5150's are held until MH or an intake nurse from our psych unit comes and sees them. It can sometimes be a very lengthy process. I've seen patients there for well over 24 hours.

Had one for 68hrs the other day.

[thelema13]

In lovely Florida, we have the Baker Act. We have held patients 72 hours waiting for acceptance at a psych facility, and before the Baker Act expires (at 72 hours) a psych doc comes in to evaluate whether or not to place another Baker on them.

It really sucks up our resources sometimes, and it really sucks that the patient's rarely get the proper help they need.

Just recently we've had a couple people roll over the 175 hour mark...

Most of the inpatient psych facilities won't take people with a history of violence... or significant medical problems... or a hx of dementia in the elderly...

Let the versed/benadryl/haldol injections roll... and mix some zyprexa in with breakfast.