Management of the Agitated Patient

Emerg Med Clin North Am. 2024 Feb;42(1):13-29. doi: 10.1016/j.emc.2023.06.010. Epub 2023 Jul 28.

Abstract

The acutely agitated patient should be managed in a step-wise fashion, beginning with non-coercive de-escalation strategies and moving on to pharmacologic interventions and physical restraints as necessary. Face-to-face examination, monitoring, and documentation by the physician are essential. The emergency physician should be familiar with multiple pharmaceutical options, tailored to the individual patient. Use of ketamine, benzodiazepines and antipsychotics should be considered. Patient autonomy, safety, and medical well-being are paramount.

Keywords: Agitation; Antipsychotics; Benzodiazepines; Physical restraints; Sedation.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents* / therapeutic use
  • Benzodiazepines / therapeutic use
  • Emergency Service, Hospital
  • Humans
  • Ketamine* / therapeutic use
  • Psychomotor Agitation / diagnosis
  • Psychomotor Agitation / drug therapy
  • Restraint, Physical

Substances

  • Ketamine
  • Antipsychotic Agents
  • Benzodiazepines