Podcast 502: EMS Psych Clearance - The Emergency Medical Minute

Podcast 502: EMS Psych Clearance

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Patients with psychiatric complaints are often complicated to disposition from the main ED, and many will require inpatient psychiatric stays
  • Some health systems have dedicated psychiatric ED’s that are specialized in taking care of these patients
  • For example, in Oakland, CA, EMS are permitted to “clear” a patient for transport to a psych-only facility.
  • 5-year retrospective study of this system showed 40% of psych patients were cleared by EMS for transfer directly to a psychiatric facility
    • Only 0.3% of these patients “bounced back” and required an emergency department visit
  • This technique could be used elsewhere to provide the most appropriate care for psych patients¬†


Trivedi TK, Glenn M, Hern G, Schriger DL, Sporer KA. Emergency Medical Services Use Among Patients Receiving Involuntary Psychiatric Holds and the Safety of an Out-of-Hospital Screening Protocol to “Medically Clear” Psychiatric Emergencies in the Field, 2011 to 2016. Ann Emerg Med. 2019 Jan;73(1):42-51. doi: 10.1016/j.annemergmed.2018.08.422. Epub 2018 Sep 28. PubMed PMID: 30274946.

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD

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