Armando Hasudungan
Biology and Medicine videos

Acute Behavioural Disturbance – agitation, psychosis, delirium

Management Talk to patient Ensure safety of self, staff and others present (eg other patients, family members), and of the patient. Summon support if Use the least invasive method necessary to gain control: verbal de-escalation and early negotiation (including the offer of oral medication) ‘show of force’ physical restraint by a trained team chemical restraint (see Behavioural emergencies: pharmacological treatment)—intravenous […]

Management

  • Talk to patient
  • Ensure safety of self, staff and others present (eg other patients, family members), and of the patient.
  • Summon support if
  • Use the least invasive method necessary to gain control:
    • verbal de-escalation and early negotiation (including the offer of oral medication)
    • ‘show of force’
    • physical restraint by a trained team
    • chemical restraint (see Behavioural emergencies: pharmacological treatment)—intravenous (IV) access is preferred if this can be safely achieved; drugs recommended for IV use include diazepam, midazolam, droperidol and olanzapine.
  • If medication has been administered, undertake post-medication monitoring and management.

Pharmacology Side effects insomnia, restlessness, anxiety, hyperprolactinaemia, neuroleptic malignant syndrome, hypotension, dystonia, prolonged QT

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