Psychological Stress and Acute Clinical Interventions

Steven Ellen
Head, Consultation-Liaison Psychiatry, The Alfred, Melbourne.
Honorary Clinical Associate Professor, Monash University, Melbourne.

Childbirth can be anxiety provoking enough without the added fears associated with anaesthesia and interventions. The anaesthetist, especially in emergency situations, is often faced with extremely anxious patients, who have very high expectations regarding their analgesia or anaesthesia and their experience of the process. Even if things go well, normal reactions can include fear, anger and disappointment, right through to severe stress reactions such as posttraumatic stress disorder and depression.

The anaesthetist has a unique opportunity to influence the process by providing acute psychological interventions as well as the usual pharmacological strategies. Typical interventions include breathing techniques, progressive muscle relaxation and hypnosis, all of which can be done quickly and with minimal training. These will be described and demonstrated.

Other clinical situations that will be addressed will include an approach to panicking patients and phobic patients (hospital or needle phobias), and addressing the barriers to good psychological care such as clinician confidence, fears about inappropriate reassurance to patients and overcoming the challenges posed by the need for urgency.

Time of Presentation
1330