Assessment of Uncooperative Patient (Examination of non-cooperative Patient) Kirby's Proforma

Initial psychiatric assessment of the uncooperative patient can often be quite challenging. It is difficult to fully assess an uncooperative patient. The complete psychiatric evaluation usually cannot be completed until the patient is calm enough to participate in a psychiatric interview. In the absence of any laboratory-based test for diagnosis, an uncooperative patient challenges any health care provider. Nonetheless, emergency clinicians must perform their duty of providing care as soon as the agitated patient presents to an emergency setting. For this reason, the psychiatric evaluation of an uncooperative patient becomes valuable for the same. In this regard Kirby’s proforma plays an important role in providing a semi-structured format in the assessment of uncooperative patients. The focus of the evaluation is on developing a reasonable differential diagnosis, ascertaining safety and self-care concerns, and deciding how to manage the agitation.
Psychiatric evaluation of the agitated patient includes visual observation of the patient before the direct patient interview and paying careful attention to the patient's verbal and nonverbal interaction with the examiner during de-escalation. Collateral information can be very helpful. While de-escalation is in process, another team member can obtain verbal reports from family, paramedics, or police officers or review written material that may accompany the patient.
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[@tejasgolhar]

Thank you, Sir, for this video. I was just now demonstrating to my registrar how to do MSE based on Kirby's proforma. I was trying to look up the proforma on Google to explain what I was doing and your video popped up very helpfully! And I am glad I got to experience another Masterclass from you for my own continued learning! Hope you are well.

[@SureshBadaMath]

All the best…Tejas

[@mariappankarthikeyan3311]

Dear respected sir, I am karthikeyan from tamilnadu. I am diagnosed with psychiatric disease bipolar disorder... Your presentations gives more acccuracy to me and my mental health. Finally for myself .... You. are the treasure for psychiatric field.. God may bless you

[@SureshBadaMath]

Thank you very much for your kind words and wishes

[@anaghaunnikrishnan176]

Thankyou so much for such wonderful classes.

[@SureshBadaMath]

All the best

[@sriramswamy8098]

So good

[@swatioberoi515]

Sir kindly make more and more videos on basics like mse history..ur video s are very useful for resident s thanks sir

[@affiliatepro5802]

Thank you sir❤

[@SureshBadaMath]

Welcome

[@SureshBadaMath]

Sure Swati

[@obotedaniel1222]

Thanks Dr for this.. however, how can uncooperative patient obey these instructions?!

[@SureshBadaMath]

Yes, we need to document the responses of an uncooperative patient to these instructions

[@sudharani8318]

Hello sir one more lucid vedeo! please if possible show the form to be filled when we use restraints

[@SureshBadaMath]

I will do the video at the earliest. Thank you very much for your feedback

[@Sumit1231ad]

Gud lecture

[@SureshBadaMath]

Thank you very much for the feedback

[@swatioberoi515]

Plz make child history and mse

[@harshithareddygs1545]

Great presentation sir..can this be used in violent, aggressive pts

[@SureshBadaMath]

It is for any uncooperative patients

[@harshithareddygs1545]

Thank you sir

[@Botoshel19]

Or they could be just normal human beings and you might misinterpret and misjudge,etc. you get the point I’m sure 😏 You know what I find funny? This video begins (as I’ve seen in many of these videos relating to mental health; it’s basically spread across the entire field) with the assumption that the person does indeed have a problem which must be identified. Is that so? I would like to know how many people are labeled as “mentally ill” or “misdiagnosed” with a mental disorder when in reality there’s absolutely nothing wrong with them. Cause we don’t hear that do we? Somehow they always find something (altough it’s the only field of medicine if you can call this practice that,that has the highest rates of misdiagnoses and harms done to people) to justify their actions.