Psychiatric issues in medical-surgical disaster casualties: A consultation-liaison approach

Psychiatrists can increase the efficacy of their response to disaster victi ms in the immediate aftermath of a disaster if they utilize a consultation- liaison approach to assessment and management of casualties. Medical-surgic al disaster responders use an algorithmic, stepwise approach to assess disa ster or trauma victims. This approach ensures that patients with life-threa tening injuries who are not expectant are treated first. Then, secondary ph ysical assessments ensure proper triage of other victims so that disaster r esponse resources are used most wisely. A tertiary psychiatric assessment c an assist with differential diagnosis of post-disaster neuropsychiatric sym ptoms and signs to ensure valuable medical-surgical resources are targeted to the correct patients. Psychiatric triage can also identify those victims most in need of early preventive and therapeutic psychiatric intervention.