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Violence (Clinical presentation (Shouting/chanting, Restless, Clenched…
Violence
Clinical
presentation
Shouting/chanting
Restless
Clenched fists
Repetitive movements
Gesticulations
Aetiology
Psychological
Psychiatric illness
Personality disorder
Environmental
Overcrowding
Noise
Alienation
Physical
Physical illness
Substance misuse
Management
Conservative
(de-escalation)
Talk calmly reassure, open
and attentive, listen
Keep self safe (don't be alone,
keep close to door)
Get help e.g. security
Attempt to gain consent for treatment
Try to take them out of crowded area
(avoid harm to others, reduce triggers)
Medical
(rapid tranquilisation)
E.g. benzo if on antipsychotic already (e,g. lorazepam, diazepam)
antipsych if not on already (e.g. haloperidol, olanzepine)
Route: PO if possible, IM if PO fails
or putting self/others at risk
Indication: last resort when
non-pharmacological methods fail
NB. regular obs and ECG monitoring,
bloods if high doses used
Definition
Acts of verbal or physical aggression
towards another person