PICOT

P: People with depression

I: Use of antidepressants 

C: Combination and antidepressants and psychotherapy

O: Depression decreased greatly.

T: Six weeks

With depressed patients, how does the use of combination of antidepressants and psychotherapy treatments compared to the use of antidepressants successfully improve patient symptoms within six weeks’ time period? 

 

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 Missy is 3 years old. She enjoys being with mom and grandma in the kitchen. She pulls a chair close to the stove, climbs on the chair and looks inside the pot of boiling water. The steam is hot on her face, she steps back and as she falls off the chair, the boiling water is pulled down on her. Missy is rushed to the emergency department. Grandma has put some butter on her fingers, but her face was not treated. 

 After several days the doctor begins discussing grafting of the hands and face. Can you educate the parents on the care the child will need. What is the home care situation for this child? Please also discuss long term issues, physical, emotional, how will she relate to peers? 

 

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 Roslyn is complaining of severe pain. She is 6 years old and has been placed in public school for the first time. Now she is complaining of her legs hurting. She is so excited about being in school finally, but her parents report that she is not participating in play time, seems weaker, and is pale. She is diagnosed with sickle cell anemia, parents undergo genetic testing as well as all her siblings and it is found that she is the only child with the disease. 

 Once the crisis is over what education will you provide to Roslyn and her parents?
Discharge teaching should include?
Is it appropriate that Roslyn stay in school? What about activities? 

 

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 Intimate Partner Violence: A 30 y/o woman presents to the Emergency Department with a complaint of sexual assault by a co-worker in her office. She has no facial or body trauma, bruising or lacerations. She is withdrawn, crying and relates feeling very guilty about coming into the clinic but is afraid of getting pregnant. They had begun dating a week ago, but she never believed this man would become so aggressive. 

Care for this patient does not conclude at the end of this ED visit.

What follow up care should be provided?

Who is best suited to provide care to this patient?

 

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