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Management of psychomotor agitation in the ER: Evidence based medicine, between guidelines and clinical practice

Published online by Cambridge University Press:  16 April 2020

M. Allen
Affiliation:
Department of Inpatient Psychiatry, Colorado Psychiatric Hospital University, Denver, CO, USA
C. Damsa
Affiliation:
Geneva, Switzerland

Abstract

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Educational Objectives

The participant should be able to recognize differences between guidelines and clinical practice for management of psychomotor agitation in emergency departments, from an up-to date literature review.

Management of psychomotor agitation raises nosological, diagnostic, legal, ethical and even logistical questions for an emergency department. In spite of continuous efforts to build consensus guidelines for treatment of behavioral emergencies based on evidence (1), clinicians continue to resist the use of such guidelines. Clinicians tend to be skeptical regarding evidence-based guidelines and wary of standardized tools. Nevertheless, data from some recent studies suggest that the systematic use of guidelines is associated with better outcomes in management of psychomotor agitation.

Several aspects of the management of psychomotor agitation will be discussed:

  1. 1) Differential diagnosis and neurobiological basis of psychomotor agitation (Adam E, Marcoz N, Maris S, Lazignac C, Damsa C).

  2. 2) Expert Consensus guidelines of management of psychomotor agitation (Allen M), [1].

  3. 3) Heisenberg in the emergency room and psychomotor agitation (Damsa C, Allen A), [2].

  4. 4) Suicide and violence in the ER: the interest of standardized measures (Cailhol L, Damsa C, Kawhol, W, Cicotti A, Lazignac C, Stamatoiu D).

  5. 5) US Expert consensus guidelines and European clinical experiences from Switzerland, Belgium, France, Luxembourg and Romania. (Lazignac C, Mihai A, Adam E, Maris S, Pull C, Damsa C).

Keywords

Emergency psychiatry, agitation, guidelines, neurobiology.

Speaker's provenience: Switzerland, France, Belgium, Germany, United States, Romania.

Type
W09. Workshop: Management of Psychomotor Agitation in the ER: Evidence based Medicine, between Guidelines and Clinical Practice
Copyright
Copyright © European Psychiatric Association 2007

References

Allen, M.H., Currier, G.W., Carpenter, D., Ross, R., Docherty, J.P.The Expert Consensus Guideline Series Treatment of Behavioral Emergencies 2005 Journal of Psychiatric Practice 11suppl 12005Google Scholar
Damsa, C., Ikelheimer, D., Adam, E., Maris, S., Lazignac, C., Andreoli, A., Allen, M.H. Heisenberg in the ER: A possibly beneficial observer effect in a psychiatric emergency service. General Hospital Psychiatry 2006 in pressGoogle Scholar
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