European Psychiatry - Volume 33 - March 2016

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S196 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
the best outcomes. Pre-hospital management of agitation requires
appropriate measures to preserve patients’ safety, stabilize the
patient and alleviate suffering, and transfer to the hospital psychi-
atric services, including involuntary admission if needed.
Objectives To describe themanagement of agitation by the Emer-
gency Medical Services (EMS) in Spain.
Methods Observational retrospective survey on the protocols and
procedures used, the number of in-calls received and the resources
dedicated to attend emergencies in 2013.
Results Seven out of the seventeen EMS in Spain provided infor-
mation. All of them registered in a database in-calls and actions
taken. Four of them had a specific protocol to attend psychiatric
emergencies and agitation in-calls, and five coded the initial diag-
nostic with ICD-9. Paramedics attending emergencies register the
diagnostic in 3/7 EMS. Nursing andMedical staff code the final diag-
nostic with ICD-9 in all. Emergency Coordination Centres received
4,437,388 in-calls (209/1000 inhabitants); 2.6% classified as psy-
chiatric (6.2/1000 inhab.). Healthcare teams attended 2,028,467
emergencies, 84,933 (4.2%) were psychiatric (4.0/1000 inhab.) and
37,951 (1.9%) were patients with agitation (2.0/1000 inhab.). Gen-
eral practitioners attended 17% of all psychiatric emergencies,
while ambulances attended 61%.
Conclusions The incidence of acute agitation accounts for almost
half of the total psychiatric emergencies in the pre-hospital setting.
Since there are different healthcare providers in charge, specific
protocols aswell as treatment procedures are needed to provide the
most adequatemanagement, in order to ensure the best Psychiatric
Emergency Chain.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW239
Recognizing high-risk behavioural
patterns in emergency psychiatry:
From surveillance to technical
assistance, insights into an innovative
project* from the point of view of
potential users
B.S. Voigtlaender ∗, D. Schölzel , A. Schönherr , J. Schloßhauer ,
T. Barth
1 Klinikum Chemnitz gGmbH, Psychiatry- Behavioural Medicine and
Psychosomatics, Chemnitz, Germany
2 Klinikum Chemnitz gGmbH, Klinikum Chemnitz gGmbH, Chemnitz,
Germany
3 Intenta GmbH, Intenta GmbH, Chemnitz, Germany
∗ Corresponding author.
Introduction After legal restrictions regarding coerced medica-
tion in Saxony, we monitored significant increases in aggressive
behaviour and regarding the use of physical restraints at our closed
psychiatric ward. Alternative measures for managing dangerous
behaviour were discussed.
Objectives There are limitations regarding the use of treatment
interventions in emergency psychiatry, e.g. the use of constant
observation is limited in its efficiency generally and video surveil-
lance is prohibited by law in high-risk areas (e.g. bathroom).
Aims To find appropriate solutions for patient safety improve-
ment in emergency psychiatry including high-risk areas, prospects
of the field of “technical assistance” entered the limelight of inter-
est.
Methods In 2014, a cooperation of Chemnitz University of Tech-
nology, Intenta GmbH, Eckstein Design and the affiliated partner
Klinikum Chemnitz started a project*, which focuses on the
development of a technical assistance system for recognizing high-
risk behavioural patterns (e.g. suicide attempt) in risk areas in
emergency psychiatry. The system is based on a smart-sensor tech-
nology and waives a recording and storing of sound and vision.
Results In the 1st half of the project technical development
and the design of the system were the focus of attention. Special
requirements regarding use cases, user acceptance, data protection
and ethical concerns were processed by our psychiatric depart-
ment. Testing and further development of the system in clinical
settings are planned.
Conclusions The development of the systemmust be seen as a big
challenge in many regards. Further research is indispensable.
*Sponsored by the Central Innovation Program Mittelstand of the
Federal Ministry for Economic Affairs and Energy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW240
Does psyche pain manifest as
agitation in the emergency setting?
L. Zun ∗, L. Downey
1 Mount Sinai Hospital, Emergency Medicine, Chicago, USA
2 Roosevelt University, Health Care Policy, Chicago, USA
∗ Corresponding author.
Objectives The objective was to determine a patient’s level of
psyche pain when they present to an emergency department (ED)
andwhether therewas a relationship between this psyche pain and
the patient’s level of agitation.
Methods This was a prospective study using a convenience
sample of 300 patients presenting to an EDwith a psychiatric com-
plaint. This study was conducted in an urban, inner-city trauma
center with 60,000 ED visits a year. After obtaining consent, a
research fellow administered validated tools for assessing agita-
tion, BAM, PANSS-EC, ACES, assessment of psyche pain, MBPPAS
and a self-assessment of agitation at admission. SPSS version 22
was used for statistical analysis and the study was IRB approved.
Results A total of 74 patients were enrolled at this time. Themost
common ED diagnoses were depression, schizophrenia, or bipolar
disorder. Majority of patients were African-American (59%), falling
in the 25–44-year-old age range (56%). Fifty-two percent male and
48% female. Psyche painwas rated byMBPPAS as marked (18.9%) or
moderate (67.6%). The self-reported tool demonstrated 20% none,
16%mild, 21%moderate and 42%marked level of agitation. The agi-
tation rating varied by the tool with self-reported level of agitation
having the highest correlation with level of psyche pain ( P< 0.05).
Conclusions Psychiatric patients frequently present to the emer-
gency department with a high level of psyche pain and high level
of self-reported agitation. This correlation may signal the need to
address a patients’ level of agitation early in evaluation process.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Epidemiology and social psychiatry
EW241
Health related quality of life in adults
with ADHD symptoms: A population
survey using 15D and AAQoL
L. Alaheino ∗, S. Leppämäki , T. Partonen , M. Sainio
1 National Institute for Health and Welfare, Mental Health Unit,
Helsinki, Finland