Background: Patients needing inpatient/residential care are often at considerable medical risk. In this workshop, best practices--based on current medical literature and on clinical consensus from a medical stabilization center--will be discussed in great detail. Best for practitioners with significant medical experience, as it will provide highly detailed information to use immediately.
I. Introduction
- Why medical optimization improves mental health IP/res care
- Why standard practices are a good idea and how to revamp them
II. How this talk is different from the usual medical overview
- Intensive for program directors, nurses, and those who oversee standard medical practices
- Highly detailed practical workups
- Use of medical evidence
- Order sets and time courses for treatment
III. In restricting
- Admission day (what to send stat)
- First 5 days of care: refeeding syndrome (phosphorus and refeeding), hypoglycemia, high liver function tests, gastroparesis, constipation, bradycardia, hypothermia, high INR, bone marrow suppression, lagophthalmos, dysphagia, thyroid abnormalities, and others
- Ongoing care: bone density evaluations, oral contraceptives
IV. In purging
- Admission day
- First five days of care: volume management, preventing rebound edema/diagnosis and management of PseudoBartter Syndrome, acute sialadenosis, hypokalemia
- Ongoing care: Constipation management
V. Stuff you shouldn’t manage in res
1. SMA syndrome, persistent hypoglycemia, severe electrolyte dysfunction
2. Hx severe rebound edema in purging
In this workshop, Dr. Gaudiani aims to give a detailed, very medical talk specifically to the doctors and nurses who run inpatient, and residential programs. We need to improve and standardize the medical evaluation and treatment of patients who present to these programs, even as they receive excellent psychotherapeutic support. The goal is to have concrete, useful, and thorough management strategies, and to know when a patient is too medically unstable for these settings.
Dr. Jennifer L. Gaudiani, MD, CEDS, is the Associate Medical Director of ACUTE and an Associate Professor of Medicine at the University of Colorado School of Medicine. She oversees the clinical, strategic, and administrative management of ACUTE, attends on the service, and maintains engagement with patients when not attending clinically. Dr. Gaudiani completed her undergraduate work at Harvard College, earned her medical degree from Boston University School of Medicine, and completed her residency and chief residency in Internal Medicine at Yale. Dr. Gaudiani has published extensively medical complications of eating disorders and has lectured nationally and internationally on the topic.
