Acute Psychosis in a Young Man: Assessment and Immediate Management
A branching clinical case simulation for a patient presenting with brought in by police with paranoid delusions, auditory hallucinations and agitation. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 4medium20 min6 stages
- Patient
- 23 years, male
- Presenting complaint
- Brought in by police with paranoid delusions, auditory hallucinations and agitation
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
A 23-year-old man is brought to the emergency department by police. He is agitated, shouting that he is being followed, and appears to be responding to unseen voices. He is unable to give a coherent history. His friend told police he has been smoking cannabis heavily for the past week. You are the junior doctor on shift. Your task is to assess and manage him safely.
What this case teaches
Assess risk and capacity; exclude organic causes; use de-escalation before rapid tranquillisation; choose and dose medication safely; apply mental health legislation appropriately.
How the case unfolds
- 1Initial Approach and HistoryHistory
- 2Physical and Mental State ExaminationExamination
- 3Excluding Organic CausesInvestigations
- 4Formulation and Risk AssessmentDiagnosis
- 5Immediate Management and Rapid TranquillisationTreatment
- 6Monitoring and Legal FrameworkMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
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A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.