Prevention in Neurological and Psychiatric Crises – Stephen Trevick, MD

Prevention can be practiced in almost any scenario – all the way from primary prevention to quaternary prevention in end-of-life situations. Furthermore, there are various social aspects that also play a role in prevention such as improving outcomes due to improved communication with patients and families or not isolating psychiatric patients and preventing a future crises.

In this episode I speak with Dr. Stephen Trevick a triple-board certified physician in neurology, psychiatry, and neurocritical care about how a preventive approach can have a large impact even in an ICU setting. We talk about keeping people out of the neuro-ICU, talking to patients and families regarding critical situations, end-of-life discussions, and even dive into the prevention of psychiatric crises. This episode has a lot of concepts that might not sound related to preventive medicine at first but still play a critical role in improving the quality of life of patients and families. Hopefully you enjoy this episode!

Dr. Trevick has no social media!

Show Outline:

  1. You have a broad range of interests and are triple board certified, how do you use your knowledge on a day to day basis?
  2. Given the many hats that you wear, what does preventive medicine mean to you?
  3. Boring questions first: How do you keep yourself out of the neurocritical care unit. what risk reducing practices reduce the risk for neurological catastrophes? (Can decide whether or not you want to talk about this one since it’s mostly pretty straightforward)
  4. We’ve talked about more common outpatient type mental illness topics on the podcast before but never about acute psychiatric needs. What is the difference between “poor mental health” and “psychiatric crisis?”
  5. How do psychiatric crises develop and how do we reduce the risk for them? Is it all about medication? Communication and support?
  6. Some psychiatric illnesses leave patient’s isolated by the medical system, how can we as physicians communicate with these patients when they have seemingly become “closed off?”
  7. In medicine we often do a poor job of communicating medical events and prognosis to both patients and family, can improving this communication improve a patient’s quality of life?
  8. Whether from a psychiatric or neurological diagnosis, patient’s families may experience significant grief. What is the physician’s role in that grief response?
  9. If someone recognizes you in the hospital starbucks line and asks you “how do I get healthy?” What do you tell them in 2 minutes?

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