Book contents
- Behavioral Emergencies for the Emergency Physician
- Behavioral Emergencies for the Emergency Physician
- Copyright page
- Contents
- Contributors
- Preface
- Section 1. General considerations for psychiatric care in the emergency department
- Section 2. Evaluation of the psychiatric patient
- Section 3. Psychiatric illnesses
- Section 4. Treatment of the psychiatric patient
- Chapter 21 Use ofverbal de-escalation techniques in the emergency department
- Chapter 22 Use ofagitation treatment in the emergency department
- Chapter 23 Management of aggressive and violent behavior in the emergency department
- Chapter 24 Restraint and seclusion techniques in the emergency department
- Chapter 25 Use ofpsychiatric medications in the emergency department
- Chapter 26 The patient withneuroleptic malignant syndrome in the emergency department
- Chapter 27 Treatment ofpsychiatric illness in the emergency department
- Chapter 28 Rapidly acting treatment in the emergency department
- Section 5. Special populations
- Section 6. Administration of psychiatric care
- Index
Chapter 22 - Use ofagitation treatment in the emergency department
from Section 4. - Treatment of the psychiatric patient
Published online by Cambridge University Press: 05 April 2013
Edited by
Book contents
- Behavioral Emergencies for the Emergency Physician
- Behavioral Emergencies for the Emergency Physician
- Copyright page
- Contents
- Contributors
- Preface
- Section 1. General considerations for psychiatric care in the emergency department
- Section 2. Evaluation of the psychiatric patient
- Section 3. Psychiatric illnesses
- Section 4. Treatment of the psychiatric patient
- Chapter 21 Use ofverbal de-escalation techniques in the emergency department
- Chapter 22 Use ofagitation treatment in the emergency department
- Chapter 23 Management of aggressive and violent behavior in the emergency department
- Chapter 24 Restraint and seclusion techniques in the emergency department
- Chapter 25 Use ofpsychiatric medications in the emergency department
- Chapter 26 The patient withneuroleptic malignant syndrome in the emergency department
- Chapter 27 Treatment ofpsychiatric illness in the emergency department
- Chapter 28 Rapidly acting treatment in the emergency department
- Section 5. Special populations
- Section 6. Administration of psychiatric care
- Index
Summary
Emergency physicians are frequently required to care for unknown patients with acute undifferentiated agitation. Agitation is known to be associated with several other psychiatric and medical causes. Agitation, regardless of the etiology, is a behavioral emergency. Both typical (first-generation) and atypical (second-generation) antipsychotics are frequently used in the management of agitation. Several of the typical antipsychotics have been associated with QT prolongation and torsades de pointes. Other acute adverse effects of antipsychotic use in the treatment of acute agitation include anticholinergic effects, movement disorders, and neuroleptic malignant syndrome. Benzodiazepines are commonly used in the acute management of agitation. In addition to rapid sedation, ketamine's short duration of action, parenteral administration, and in particular the preservation of protective airway reflexes, are attractive properties in the management of patients with acute agitation. According to the Joint Commission Standards, restraints can only be used when clinically justified or when warranted by patient behavior.
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- Behavioral Emergencies for the Emergency Physician , pp. 164 - 169Publisher: Cambridge University PressPrint publication year: 2013