Weitere Artikel dieser Ausgabe durch Wischen aufrufen
M. Christ, Nürnberg
F.-G.B. Pajonk, Kloster Schäftlarn
Die komplette deutsche Übersetzung des Beitrags finden Sie auf SpringerLink unter dx.doi.org/10.1007/s10049-016-0159-4.
Behavioral emergencies are frequent occurrences in the emergency room setting. They are associated with an increased risk of harm to patients and staff, and specific training is needed to ensure proper assessment and treatment, including verbal de-escalation techniques, medications, and restraints.
The objective of this study was to define behavioral emergencies, review causes and assessment of them, and to discuss treatment strategies based on a systematic review of the literature.
Publications in PubMed from 1980–2015 were accessed using key terms of behavioral emergency, agitation, aggression, psychiatric emergencies, restraints, and delirium.
A review of definition, diagnosis, and treatment of behavioral emergencies is provided. New treatment approaches which include the use of standardized agitation scales to objectively measure agitation, verbal de-escalation techniques, and focusing on oral medications rather than parenteral medications are detailed.
Utilizing verbal de-escalation techniques in the emergency room setting is quick and often prevents further escalation of behaviors. Second generation antipsychotic medications are as effective as first generation antipsychotics without cardiac and extrapyramidal side effects and are to be favored in most cases of acute agitation. Oral medications are preferred to parenteral if possible.
The German full-text version of this article is also available at SpringerLink under dx.doi.org/10.1007/s10049-016-0159-4.
Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten
Sie möchten Zugang zu diesem Inhalt erhalten? Dann informieren Sie sich jetzt über unsere Produkte:
Association AP (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Arlington, pp 596–597
Amos JJ, Robinson RG (2010) Psychosomatic medicine. Cambridge University Press, Cambridge, pp 58–72 CrossRef
Gerson SI, Bassuk E (1980) Psychiatric emergencies: an overview. Am J Psychiatry 137:1–11 PubMed
Nassissi D et al (2006) The evaluation and management of the acutely agitated elderly patient. Mt Sinai J Med 73(7):976–984
Thomas CL (ed) (1981) Taber’s Cyclopedic medical dictionary. Edited by Clayton L. Thomas, MD, MPH and published by F. A. Davis Co., Philadephia.
Weigel MB et al (2009) Treatment of Psychiatric Emergencies. The American Publishing Textbook of Psychopharmacology, 4th edn. (Chapter 62). Edited by Alan F. Schatzberg, MD and Charles B. Nemeroff, MD, PhD. Published by American Psychiatric Association in Arlington, VA.
Wilson MP, Nordstrom K, Vilke GM (2015) The agitated patient in the emergency department. Current Emerg Hosp Med Rep 3:188–194 CrossRef
Zeller SL, Rhoades RW (2010) Systematic Reviews of Assessment Measures and Pharmacologic Treatments for Agitation. Clin Ther 32:3 CrossRef
Alexander J et al (2007) Rapid tranquillisation of violent or agitated patients in a psychiatric emergency setting. Br J Psychiatry 335:63–69
Bender D, Pande N, Ludwig M (2009) Psychiatric boarding interview summary. U.S. Department of Health and Human Services, Washington DC
Convit A, Isay D, Otis D et al (1990) Characteristics of repeatedly assaultive psychiatric inpatients. Hosp Community Psychiatry 41:1112–1115 PubMed
Pacciardi B et al (2013) Issues in the management of acute agitation: how much current guidelines consider safety? Front Psychiatry 4:1–10 (Article 26) CrossRef
- Behavioral emergencies in adults. Assessment and treatment
MD Elaine Himadi
- Springer Berlin Heidelberg