Agitation: A Clinical Review for Emergency Physicians
Always initiate management with non-pharmacologic measures, prioritizing verbal de-escalation regardless of the perceived severity. Remember that the underlying cause of the agitation dictates the best next steps, so don't just treat the agitation itself. While medication is necessary sometimes, always pair it with a systematic approach involving the whole team to minimize restraints.
This review provides a comprehensive overview of managing agitation in the emergency department, emphasizing a multi-faceted approach rather than relying solely on pharmacologic intervention. The authors strongly advocate for establishing verbal de-escalation as the cornerstone and first-line strategy for managing agitated patients. Beyond de-escalation, effective care hinges on a thorough consideration of the underlying etiology of the agitation, which should guide subsequent management decisions. Furthermore, the integration of multidisciplinary teamwork is highlighted as critical for improving patient care quality and reducing adverse events. Adherence to these principles is suggested to decrease the reliance on physical restraints and mitigate the risk of workplace violence among ED staff.