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" Verbal De-escalation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup "
Richmond, Janet S.; Berlin, Jon S.; Fishkind, Avrim B.; Holloman, Garland H.; Zeller, Scott L.; Wilson, Michael P.; Rifai, Muhamad Aly; Ng, Anthony T.
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AL
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| Record Number
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934158
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LA55g994m6
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| Language of Document
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English
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| Main Entry
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Richmond, Janet S.; Berlin, Jon S.; Fishkind, Avrim B.; Holloman, Garland H.; Zeller, Scott L.; Wilson, Michael P.; Rifai, Muhamad Aly; Ng, Anthony T.
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| Title & Author
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Verbal De-escalation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup [Article]\ Richmond, Janet S.; Berlin, Jon S.; Fishkind, Avrim B.; Holloman, Garland H.; Zeller, Scott L.; Wilson, Michael P.; Rifai, Muhamad Aly; Ng, Anthony T.
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Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
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13/1
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2012
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| Abstract
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Agitation is an acute behavioral emergency requiring immediate intervention. Traditional methods of treating agitated patients, ie, routine restraints and involuntary medication, have been replaced with a much greater emphasis on a noncoercive approach. Experienced practitioners have found that if such interventions are undertaken with genuine commitment, successful outcomes can occur far more often than previously thought possible. In the new paradigm, a 3-step approach is used. First, the patient is verbally engaged; then a collaborative relationship is established; and, finally, the patient is verbally deescalated out of the agitated state. Verbal de-escalation is usually the key to engaging the patient and helping him become an active partner in his evaluation and treatment; although, we also recognize that in some cases nonverbal approaches, such as voluntary medication and environment planning, are also important. When working with an agitated patient, there are 4 main objectives: (1) ensure the safety of the patient, staff, and others in the area; (2) help the patient manage his emotions and distress and maintain or regain control of his behavior; (3) avoid the use of restraint when at all possible; and (4) avoid coercive interventions that escalate agitation. The authors detail the proper foundations for appropriate training for de-escalation and provide intervention guidelines, using the ‘‘10 domains of deescalation.’’ [West J Emerg Med. 2012;13(1):17–25.]
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