How and when should Mr Smith have been screened or assessed specifically for psychological symptoms?
What will be an ideal response?
Suggested response: Screening should begin early, shortly after ICU discharge and before discharge from hospital. We know that early signs of distress predict subsequent longer term distress and, therefore, patients can be screened prior to hospital discharge. At this stage, it is important to remember that no diagnosis can be made. Mr Smith's symptoms may reduce over the next few weeks or months and we must make sure that we do not ‘medicalise' what may be part of a normal process. Cognitive function should also be assessed prior to hospital discharge. Attendance at a follow-up clinic or being reassessed by his general practitioner will be important. If he has persistent PTSS or cognitive deficits, he should be referred to the appropriate specialist.
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