For a patient who intentionally overdosed on amitriptyline, which action is the highest priority?

Obtaining a 12-lead electrocardiogram is the highest priority for a patient who has intentionally overdosed on amitriptyline due to the potential cardiac complications associated with this medication. Amitriptyline is a tricyclic antidepressant, and overdoses can lead to serious cardiovascular side effects, including arrhythmias and prolonged QT interval. Monitoring the heart's electrical activity allows healthcare providers to quickly identify any abnormal heart rhythms and intervene as needed, which is crucial for the patient's immediate safety.

While understanding the patient's reasoning for the overdose and establishing a therapeutic relationship are important aspects of care, they are not immediate priorities in a situation where a patient's life could be at risk due to cardiac complications. Consulting psychiatry is also necessary for ongoing management after immediate medical stabilization but does not take precedence over addressing potential acute physical health issues. Focusing first on the patient's cardiac status ensures that any life-threatening complications can be identified and treated promptly.