Anticholinergic Syndrome Training The community feedback period for this idea began on 9/23/19 and ended on 11/22/19.

What is the problem that needs to be addressed? Please describe how it is related to mental health.
Recognition and treatment for Anticholinergic Syndrome. A person in crisis with overlapping Anticholinergic Syndrome can be difficult to interact with to assess DTS/DTO/GD.

Anticholinergic Syndrome is summarized by the poem:

Hot as a Hare (hot dry skin)
Red as a Beet (Flushed Appearance)
Dry as a Bone (Dry mouth, dry eyes, decreased sweating)
Blind as a Bat (Mydriasis)
Mad as a Hatter (Delirium)
Full as a Flask (Urinary retention)

Why is this a concern for Orange County? What can Orange County and other counties learn from this project?
Orange County has mastered the Psych Emergency Assessment for DTS/DTO/GD and is starting to master Mental Health First Aid USA. The next step is recognizing the Anticholinergic Syndrome toxidrome and addressing the toxidrome to better utilize risk assessment/Mental Health First Aid.

What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?
Again, OC has mastered Psych DTS/DTO/GD and is starting to master Mental Health First Aid USA. Recognizing and effectively intervening for anticholinergic syndrome is the next step.

What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.
Most of the Psych providers in OC are not MD/DO. They are Ph.D., LMFT, MS, MA, or other degreed professionals not trained on the Anticholinergic Toxidrome. Recognizing and having a process to address the anticholinergic toxidrome is a REQUIRED step to effectively utilizing Mental Health First Aid and Risk Assessing DTS/DTO/GD.

The submitter makes this statement being an unlicensed professional. However, risk assessing a person in an anticholinergic crisis is, by common sense, futile.

What is the project idea? Please describe how this project will operate.
Come up with a training and process to address Anticholinergic Crisis in a similar method as Mental Health First Aid.

The Australians may be ahead of us on this one as well.

Additional Information:

September 10, 2019


If we are not recognizing Anticholinergic Syndrome when it occurs then we are probably also not recognizing Neuroleptic Malignant Syndrome when it occurs.

The DDx also involves heat stroke, heat exhaustion, neurotoxin exposure, and the many other causes of fever. Seizures and mental status changes are involved with fever.

Thank you for your submission. The Innovation team will review this idea and post comments and updates when available.

This one I would work on outside the innovations process as morbidity and mortality are in play currently. 2 years of no risk mitigation is a hard lesson to learn.

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