Patients with co-existing medical and psychiatric diagnoses can be challenging to assess, evaluate, and treat. Medical emergencies among psychiatric patients may receive delayed medical responses or remain undetected if medical emergency training and response are not in place, leading to negative patient outcomes, including death. The role of the psychiatric nurse is pivotal in recognizing and responding to acute medical complications in the inpatient psychiatric population. However, little research exists concerning the educational needs of psychiatric nurses on medical emergency situations or on the use of medical emergency treatment in psychiatric facilities. Western Psychiatric Institute and Clinic (WPIC) of the University of Pittsburgh Medical Center in Pennsylvania has recently launched specific guidelines and educational in-services for nurses and other health care professionals to utilize in determining the need for emergency medical treatment. Current data indicate these guidelines, that have psychiatric nurses playing an integral role, to be effective in improving patient outcomes in medical emergency situations. The purpose of this paper is to demonstrate the need for medical emergency strategies in psychiatric facilities and to stress the important role that psychiatric nurses play in determining the success of implemented medical emergency response strategies.