Triage, Risk Concept and Prehospital Emergencies in Psychiatric Ambulance: Proposal for Implementation in the City of Buenos Aires

This chapter describe a Triage proposal to be applied in prehospital interventions by the psychiatric ambulance dependent on the Alvear Hospital and under current legal regulations. Psychiatric emergencies are severe behavioral changes secondary to worsening mental illness. Such situations present a risk to the patient and other people, so they need immediate therapeutic intervention. They are associated with feelings of fear, anger, prejudice, and even exclusion. The study of prehospital emergency interventions with the psychiatric ambulance of our hospital was carried out through the evolutions carried out in the "Ambulance Duty Book". The triage proposal included the internationally used criteria related to time, the reason for the intervention, the clinical presentation and the proposed approach modality. The triage system is a tool that allows for the systematisation of approaches against the variety of causes for consultation and presentation of mental pathologies in the emergency room, in addition to fostering greater interventional effectiveness, system homogeneity, and consensus among the health effectors. The application of triage in mental pathologies is based not only on the response time, but also on the resources that a device has to respond to them. In the particular case of prehospital ambulance emergencies, we consider it useful and that the scenarios (of the pathology and the environment) are propitious for the implementation of this type of strategy. It is concluded that the implementation of this proposal is useful for the clinical detection and risk management of psychiatric pathologies in the prehospital context, since it allows systematizing the interventions according to the resources of each health system.