violent behavior. psychiatric emergency
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This document discusses the management of patients exhibiting violent or aggressive behavior. It notes that this behavior can be caused by organic psychiatric disorders like delirium or dementia, or other psychiatric disorders like schizophrenia, mania, or withdrawal from drugs and alcohol. The first steps in managing such a patient include removing any restraints, talking to the patient kindly but firmly, and giving sedative medications like diazepam or haloperidol. A full physical and psychiatric examination should be conducted to identify any underlying causes and ensure the patient's safety and needs are met. The environment should be kept calm and secure to minimize risks and redirect the patient's behavior.
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Psychiatric emergency
Almost all people affected by emergencies will experience psychological distress which for most people will improve over time.People with severe mental disorder are especially vulnerable during emergencies and need access to mental health care and other basic needs.
Psychiatric emergencies
Psychiatric emergencies involve conditions that require immediate psychiatric intervention and can include attempted suicide, substance abuse, depression, psychosis, or changes in behavior. Some key types of psychiatric emergencies discussed in the document are suicide, violence or excitement, panic attacks, stupor and catatonic syndrome, and drug toxicity. For each type of emergency, the document outlines characteristics, potential causes, risk factors, and general guidelines for management and treatment.
PSYCHIATRIC EMERGENCIES - SUICIDE & CRISIS INTERVENTION
This document provides information on psychiatric emergencies and crisis intervention. It discusses types of psychiatric emergencies like suicidal threats, violence, panic attacks, and drug-induced conditions. It outlines guidelines for managing these emergencies, including handling patients with tact, shifting patients to safe rooms, and reassuring other clients. The document also describes crisis intervention, including its goals of reducing stress and assisting recovery. It discusses techniques like catharsis, clarification, and reinforcement. The phases of crisis intervention include assessment, intervention planning, implementing techniques, and resolving the crisis.
Psychiatric emergency
This document provides information on various psychiatric emergencies and their management. It defines psychiatric emergency and lists common emergencies such as suicidal threats, violence, panic attacks, and catatonic stupor. For each emergency, it discusses etiology, risk factors, symptoms and management strategies. It also covers topics such as stress, grief, crisis and crisis intervention techniques. The document serves as a reference for nurses on understanding and treating different psychiatric emergencies.
Psychiatric Emergency
This document discusses psychiatric emergencies and their management. It defines a psychiatric emergency as an unforeseen situation requiring immediate action to protect the individual and others. Common emergencies include suicidal threats, violence, panic attacks, catatonic states, and drug toxicity. The goals of emergency intervention are to safeguard life, reduce anxiety, and enhance emotional security. Treatment depends on the specific condition but generally involves sedation, reassurance, searching for underlying causes, and ensuring safety. Proper handling of emergencies is important to prevent anxiety in others and allow for normal facility operations.
Anamika psychiatricemergency-180728182950
The document discusses psychiatric emergencies, which are conditions that present with altered behaviors, emotions, or thoughts that require immediate attention and care. Common psychiatric emergencies include suicidal threats, violent or aggressive behavior, panic attacks, catatonic stupor, and hysterical attacks. Organic emergencies include delirium, epileptic furor, acute drug-induced side effects, and drug toxicity. The goals of emergency intervention are to safeguard the patient's life, reduce family anxiety, and enhance others' emotional security. Proper management depends on the specific emergency and may involve sedation, reassurance, monitoring vital signs, treating underlying causes, and preventing injury.
Psychiatric emergencies in adults
A psychiatric emergency requires immediate intervention and evaluating if the cause is medical or psychiatric. Patient safety is the top priority. Features that indicate a medical cause include acute onset, age, medical issues, or substance abuse. Specific situations like psychosis, depression, violence, and sexual abuse require modified approaches. Psychotherapy and pharmacotherapy like benzodiazepines or antipsychotics may be used. Restraints are only used if less restrictive options cannot control severe threats. Thorough documentation of all assessments, decisions, and interventions is important.
Panic disorder
Panic disorder is characterized by unexpected panic attacks that occur without a discernible trigger. During attacks, patients feel an urge to flee and a sense of impending doom. Panic disorder is diagnosed based on the frequency and severity of panic attacks, as well as worry about future attacks. Treatment involves selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and cognitive-behavioral therapy, which are effective in more than 85% of cases. Long-term prognosis is generally good, with remission occurring within 6 months for 65% of patients.
Recommended
Psychiatric emergency
Almost all people affected by emergencies will experience psychological distress which for most people will improve over time.People with severe mental disorder are especially vulnerable during emergencies and need access to mental health care and other basic needs.
Psychiatric emergencies
Psychiatric emergencies involve conditions that require immediate psychiatric intervention and can include attempted suicide, substance abuse, depression, psychosis, or changes in behavior. Some key types of psychiatric emergencies discussed in the document are suicide, violence or excitement, panic attacks, stupor and catatonic syndrome, and drug toxicity. For each type of emergency, the document outlines characteristics, potential causes, risk factors, and general guidelines for management and treatment.
PSYCHIATRIC EMERGENCIES - SUICIDE & CRISIS INTERVENTION
This document provides information on psychiatric emergencies and crisis intervention. It discusses types of psychiatric emergencies like suicidal threats, violence, panic attacks, and drug-induced conditions. It outlines guidelines for managing these emergencies, including handling patients with tact, shifting patients to safe rooms, and reassuring other clients. The document also describes crisis intervention, including its goals of reducing stress and assisting recovery. It discusses techniques like catharsis, clarification, and reinforcement. The phases of crisis intervention include assessment, intervention planning, implementing techniques, and resolving the crisis.
Psychiatric emergency
This document provides information on various psychiatric emergencies and their management. It defines psychiatric emergency and lists common emergencies such as suicidal threats, violence, panic attacks, and catatonic stupor. For each emergency, it discusses etiology, risk factors, symptoms and management strategies. It also covers topics such as stress, grief, crisis and crisis intervention techniques. The document serves as a reference for nurses on understanding and treating different psychiatric emergencies.
Psychiatric Emergency
This document discusses psychiatric emergencies and their management. It defines a psychiatric emergency as an unforeseen situation requiring immediate action to protect the individual and others. Common emergencies include suicidal threats, violence, panic attacks, catatonic states, and drug toxicity. The goals of emergency intervention are to safeguard life, reduce anxiety, and enhance emotional security. Treatment depends on the specific condition but generally involves sedation, reassurance, searching for underlying causes, and ensuring safety. Proper handling of emergencies is important to prevent anxiety in others and allow for normal facility operations.
Anamika psychiatricemergency-180728182950
The document discusses psychiatric emergencies, which are conditions that present with altered behaviors, emotions, or thoughts that require immediate attention and care. Common psychiatric emergencies include suicidal threats, violent or aggressive behavior, panic attacks, catatonic stupor, and hysterical attacks. Organic emergencies include delirium, epileptic furor, acute drug-induced side effects, and drug toxicity. The goals of emergency intervention are to safeguard the patient's life, reduce family anxiety, and enhance others' emotional security. Proper management depends on the specific emergency and may involve sedation, reassurance, monitoring vital signs, treating underlying causes, and preventing injury.
Psychiatric emergencies in adults
A psychiatric emergency requires immediate intervention and evaluating if the cause is medical or psychiatric. Patient safety is the top priority. Features that indicate a medical cause include acute onset, age, medical issues, or substance abuse. Specific situations like psychosis, depression, violence, and sexual abuse require modified approaches. Psychotherapy and pharmacotherapy like benzodiazepines or antipsychotics may be used. Restraints are only used if less restrictive options cannot control severe threats. Thorough documentation of all assessments, decisions, and interventions is important.
Panic disorder
Panic disorder is characterized by unexpected panic attacks that occur without a discernible trigger. During attacks, patients feel an urge to flee and a sense of impending doom. Panic disorder is diagnosed based on the frequency and severity of panic attacks, as well as worry about future attacks. Treatment involves selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and cognitive-behavioral therapy, which are effective in more than 85% of cases. Long-term prognosis is generally good, with remission occurring within 6 months for 65% of patients.
psy schizo syahida.ppt
Schizophrenia is a mental disorder characterized by abnormalities in thinking, emotion, and behavior. The symptoms can be divided into positive (e.g. hallucinations), negative (e.g. social withdrawal), and cognitive symptoms. The phases include a prodromal phase with declining functioning, a psychotic phase with clear symptoms, and a residual phase with milder symptoms. Treatment involves antipsychotic medications and hospitalization may be needed for severe symptoms or risk of harm. Clozapine is effective for treatment-resistant schizophrenia.
Psychiatric emergencies
This document summarizes various psychiatric emergencies and their management. Common psychiatric emergencies include suicidal threats, violent behavior, panic attacks, catatonic stupor, hysterical attacks, and transient situational disturbances. Organic psychiatric emergencies include delirium tremens, epileptic furor, acute drug-induced extrapyramidal symptoms, and drug toxicity. The document provides details on the presentation and management of each of these conditions, with management focusing on ensuring patient safety, medication administration, reassurance, and addressing the underlying causes.
Psychiatric emergencies
This document discusses various psychiatric emergencies and their management. It describes conditions like suicidal threats, violence, panic attacks, catatonia, hysteria, transient situational disturbances, delirium tremens, epileptic furor, acute drug-induced movement disorders, and drug toxicity. For each condition, it outlines signs, potential causes, and recommended emergency treatment approaches such as reassurance, sedation, monitoring safety, fluid replacement, and stopping causative medications. The overall goal of management is to stabilize the patient, prevent harm, and address the underlying psychiatric condition.
DELIRIUM
This document discusses delirium, an acute organic mental disorder characterized by impaired consciousness, disorientation, and disturbances in perception and restlessness. It notes that delirium has the highest incidence among organic mental disorders, affecting 10-25% of medical-surgical inpatients and 20-40% of geriatric patients. Causes of delirium include infections, metabolic disturbances, toxins, and withdrawal from sedative drugs. Symptoms include impaired attention, perceptual disturbances, cognitive impairment, and disturbed sleep-wake cycles. Treatment involves identifying and correcting the underlying cause, with benzodiazepines or antipsychotics used to manage symptoms. Nursing care focuses on ensuring patient safety, meeting physical needs, reducing anxiety, and facilitating orientation.
psychiatric emergencies
This document discusses various psychiatric emergencies and their management. It defines psychiatric emergency as a condition where a patient has disturbances in thought, affect, and psychomotor activity that threaten their existence or environment. Common emergencies discussed include suicidal threats, violent behavior, panic attacks, catatonic stupor, and hysterical attacks. Organic emergencies like epileptic furor and acute drug toxicity are also covered. For each emergency, risk factors, symptoms, and treatment approaches like reassurance, sedation, and removal from dangerous objects are summarized. The document stresses handling emergencies calmly to prevent anxiety in other patients.
Management of violent patient by joel o egeru
This document provides guidelines for the management of violent patients. It defines violence and aggression and lists risk factors like a history of violence, substance abuse, and acute psychiatric conditions. Clinical signs of impending violence are described. Non-coercive methods like de-escalation should be tried first to manage violent patients. If needed, coercive methods like physical and chemical restraint can be used as a last resort while ensuring patient safety and dignity. Common drugs used for chemical restraint include lorazepam, haloperidol, chlorpromazine, and olanzapine, with their proper dosages and side effects outlined.
Agoraphobia
Agoraphobia is defined as the fear of being alone in public places or situations from which escape is difficult. It affects 1-7% of the population and is often caused by having multiple panic attacks in public, leading to a fear of public places. Symptoms include anxiety and avoidance of situations that could trigger a panic attack. To be diagnosed, the DSM-IV criteria require anxiety about places where help may not be available if a panic attack occurs, along with avoidance of these situations. Treatment involves medication like SSRIs, psychotherapy, and treating any coexisting panic disorder.
Psychiatric emergencies
This slide contains information regarding Psychiatric Emergencies (Anger, Aggression and violence, Stupor and Catatonia) . This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Schizophrenia
Schizophrenia
Pathophysiology and epidemiology
Dopamine theory:
Overactive dopamine system, especially in the mesolimbic area, causes the positive symptoms of schizophrenia.
Associated brain changes:
Larger lateral ventricles.
Reduced volume of the frontal lobe, parahippocampal gyrus, hippocampus, temporal lobe, and/or amygdala.
None of these changes are especially sensitive or specific.
Epidemiology:
0.5% lifetime risk.
Medicos PDF is a platform where students can download their own medical books for free and share with their Medical friends.
impulse control disorder final
This document provides information on impulse control disorders including intermittent explosive disorder, kleptomania, pyromania, pathological gambling, trichotillomania, and impulse control disorder not otherwise specified. It discusses the epidemiology, comorbidity, etiology, diagnosis, course, prognosis, and treatment of each disorder. For each disorder, it provides the diagnostic criteria from the DSM-IV-TR and ICD-10. The document focuses in more depth on intermittent explosive disorder, kleptomania, pyromania, and pathological gambling by including sections on their specific etiologies, clinical features, and treatments.
occupational therapy for epilepsy: an overview
This document discusses epilepsy, its causes, prevention, and the role of occupational therapy. It defines epilepsy as abnormal neuronal discharge in the brain that can cause loss of consciousness or odd behavior. Risk factors include premature birth, brain infections, abnormal brain structures, cerebral palsy, hypoxia, brain tumors, stroke, and drug abuse. Occupational therapy focuses on safety, adaptations to the home, relaxation techniques, exercise, routine management, leisure activities, and support groups to help epileptic patients live independently and cope with emotional and cognitive challenges.
10-neurocognitive disorders.ppt
This document discusses neurocognitive disorders including delirium, major neurocognitive disorders such as dementia and amnestic syndrome, mild neurocognitive disorder, epilepsy, and traumatic brain injury. It provides details on the diagnostic criteria, clinical features, epidemiology, treatment, and prognosis of these conditions. Case studies are also presented to illustrate delirium and complex partial seizures.
PSYCHIATRIC EMERGENCIES.pptx
This document discusses common psychiatric emergencies including suicidal threats, violent or aggressive behavior, panic attacks, catatonic stupor, hysterical attacks, and transient situational disturbances. For each emergency, the document outlines potential etiologies, presenting symptoms, and general management strategies. Management often involves sedation, reassurance, searching for underlying causes, and ensuring patient safety and medical stabilization.
Delirium
The word delirium means โout of oneโs furrowโ which refers to the dramatic behavior changes that the person may experience. Some have called delirium "brain failureโ because it may represent a variety of caused such as heart failure does in cardiac health.
Delirium is an outcome of a general medical condition, head injury and drug intoxication or withdrawal.
Psych notes
Anxiety disorder occurs when a person is unable to cope with stressors that interfere with daily activities. Central to anxiety disorder is a person's misinterpretation of stressors and exaggerated response to them. A stressor is a situation that triggers a stress response.
Seizures in Childhood.pptx
This document provides an overview of seizures in childhood, including definitions, epidemiology, classification, pathophysiology, evaluation, focal seizures and related epilepsy syndromes, generalized seizures and syndromes, and treatment. Key points include that focal seizures are the most common seizure type in children, various etiologies can cause seizures, and evaluation involves a detailed history, physical exam, EEG, imaging and potentially metabolic testing to identify underlying causes and guide treatment. Common benign childhood epilepsy syndromes like BECTS are also discussed.
H.5.1-Antipsychotics-PowerPoint-2016.pptx
Antipsychotic medication and side effects , how to use antipsychotic medication, side effects of antipsychotic medication
Complication of antipsychotic medication, indecation of antipsychotic medication
Psychiatric Emergencies
This document provides information on psychiatric emergencies. It discusses conditions that require immediate psychiatric attention such as suicide, violence, catatonia, panic attacks, and victims of disasters. It outlines characteristics, objectives, types, and general guidelines for managing psychiatric emergencies. Specific conditions like suicide, violence, stupor, and alcohol withdrawal are explained in terms of epidemiology, etiology, risk factors, symptoms, and management. The nursing management of various psychiatric emergencies is also summarized, focusing on ensuring patient safety, monitoring, providing support and treatment, and creating a calm environment.
anti-NMDAR encephalitis eav
A 26-year-old female presented with rapidly progressive memory deficits, psychiatric symptoms, and language disintegration. Standard tests were unremarkable but EEG showed encephalopathy. Serum tested positive for anti-NMDA receptor antibodies on two occasions. Imaging found bilateral ovarian tumors, and pathology confirmed teratomas. First-line treatment with tumor resection, IVIG, and steroids led to rapid improvement. Anti-NMDA receptor encephalitis should be considered in similar presentations, especially in young females, as prompt diagnosis and treatment including tumor removal can lead to good outcomes.
Delirium in elderly
An 83-year-old woman presented with fever, shortness of breath, and poor oral intake. She has a history of multiple medical conditions and is on several medications. On examination, she has a fever and signs of respiratory distress. The physician is concerned about pneumonia and increased depression, but her cognitive status was not assessed. Delirium is an acute fluctuating syndrome of altered attention, awareness and cognition, especially common in elderly hospitalized patients. It is often misdiagnosed as depression or dementia. Non-pharmacological prevention and treatment of underlying causes are most important, while antipsychotics may be used short-term for severe symptoms if needed.
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psy schizo syahida.ppt
Schizophrenia is a mental disorder characterized by abnormalities in thinking, emotion, and behavior. The symptoms can be divided into positive (e.g. hallucinations), negative (e.g. social withdrawal), and cognitive symptoms. The phases include a prodromal phase with declining functioning, a psychotic phase with clear symptoms, and a residual phase with milder symptoms. Treatment involves antipsychotic medications and hospitalization may be needed for severe symptoms or risk of harm. Clozapine is effective for treatment-resistant schizophrenia.
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This document discusses various psychiatric emergencies and their management. It describes conditions like suicidal threats, violence, panic attacks, catatonia, hysteria, transient situational disturbances, delirium tremens, epileptic furor, acute drug-induced movement disorders, and drug toxicity. For each condition, it outlines signs, potential causes, and recommended emergency treatment approaches such as reassurance, sedation, monitoring safety, fluid replacement, and stopping causative medications. The overall goal of management is to stabilize the patient, prevent harm, and address the underlying psychiatric condition.
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This document discusses delirium, an acute organic mental disorder characterized by impaired consciousness, disorientation, and disturbances in perception and restlessness. It notes that delirium has the highest incidence among organic mental disorders, affecting 10-25% of medical-surgical inpatients and 20-40% of geriatric patients. Causes of delirium include infections, metabolic disturbances, toxins, and withdrawal from sedative drugs. Symptoms include impaired attention, perceptual disturbances, cognitive impairment, and disturbed sleep-wake cycles. Treatment involves identifying and correcting the underlying cause, with benzodiazepines or antipsychotics used to manage symptoms. Nursing care focuses on ensuring patient safety, meeting physical needs, reducing anxiety, and facilitating orientation.
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This document discusses various psychiatric emergencies and their management. It defines psychiatric emergency as a condition where a patient has disturbances in thought, affect, and psychomotor activity that threaten their existence or environment. Common emergencies discussed include suicidal threats, violent behavior, panic attacks, catatonic stupor, and hysterical attacks. Organic emergencies like epileptic furor and acute drug toxicity are also covered. For each emergency, risk factors, symptoms, and treatment approaches like reassurance, sedation, and removal from dangerous objects are summarized. The document stresses handling emergencies calmly to prevent anxiety in other patients.
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This document provides guidelines for the management of violent patients. It defines violence and aggression and lists risk factors like a history of violence, substance abuse, and acute psychiatric conditions. Clinical signs of impending violence are described. Non-coercive methods like de-escalation should be tried first to manage violent patients. If needed, coercive methods like physical and chemical restraint can be used as a last resort while ensuring patient safety and dignity. Common drugs used for chemical restraint include lorazepam, haloperidol, chlorpromazine, and olanzapine, with their proper dosages and side effects outlined.
Agoraphobia
Agoraphobia is defined as the fear of being alone in public places or situations from which escape is difficult. It affects 1-7% of the population and is often caused by having multiple panic attacks in public, leading to a fear of public places. Symptoms include anxiety and avoidance of situations that could trigger a panic attack. To be diagnosed, the DSM-IV criteria require anxiety about places where help may not be available if a panic attack occurs, along with avoidance of these situations. Treatment involves medication like SSRIs, psychotherapy, and treating any coexisting panic disorder.
Psychiatric emergencies
This slide contains information regarding Psychiatric Emergencies (Anger, Aggression and violence, Stupor and Catatonia) . This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Schizophrenia
Schizophrenia
Pathophysiology and epidemiology
Dopamine theory:
Overactive dopamine system, especially in the mesolimbic area, causes the positive symptoms of schizophrenia.
Associated brain changes:
Larger lateral ventricles.
Reduced volume of the frontal lobe, parahippocampal gyrus, hippocampus, temporal lobe, and/or amygdala.
None of these changes are especially sensitive or specific.
Epidemiology:
0.5% lifetime risk.
Medicos PDF is a platform where students can download their own medical books for free and share with their Medical friends.
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Delirium
The word delirium means โout of oneโs furrowโ which refers to the dramatic behavior changes that the person may experience. Some have called delirium "brain failureโ because it may represent a variety of caused such as heart failure does in cardiac health.
Delirium is an outcome of a general medical condition, head injury and drug intoxication or withdrawal.
Psych notes
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This document provides information on psychiatric emergencies. It discusses conditions that require immediate psychiatric attention such as suicide, violence, catatonia, panic attacks, and victims of disasters. It outlines characteristics, objectives, types, and general guidelines for managing psychiatric emergencies. Specific conditions like suicide, violence, stupor, and alcohol withdrawal are explained in terms of epidemiology, etiology, risk factors, symptoms, and management. The nursing management of various psychiatric emergencies is also summarized, focusing on ensuring patient safety, monitoring, providing support and treatment, and creating a calm environment.
anti-NMDAR encephalitis eav
A 26-year-old female presented with rapidly progressive memory deficits, psychiatric symptoms, and language disintegration. Standard tests were unremarkable but EEG showed encephalopathy. Serum tested positive for anti-NMDA receptor antibodies on two occasions. Imaging found bilateral ovarian tumors, and pathology confirmed teratomas. First-line treatment with tumor resection, IVIG, and steroids led to rapid improvement. Anti-NMDA receptor encephalitis should be considered in similar presentations, especially in young females, as prompt diagnosis and treatment including tumor removal can lead to good outcomes.
Delirium in elderly
An 83-year-old woman presented with fever, shortness of breath, and poor oral intake. She has a history of multiple medical conditions and is on several medications. On examination, she has a fever and signs of respiratory distress. The physician is concerned about pneumonia and increased depression, but her cognitive status was not assessed. Delirium is an acute fluctuating syndrome of altered attention, awareness and cognition, especially common in elderly hospitalized patients. It is often misdiagnosed as depression or dementia. Non-pharmacological prevention and treatment of underlying causes are most important, while antipsychotics may be used short-term for severe symptoms if needed.
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2- ุชุญุชูู ุนูู 78 ุฑุณู
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4- ูููุงูู ุจุนุถ ุงูู
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violent behavior. psychiatric emergency
- 1. VIOLENT OR AGGRESSIVE BEHAVIOR OR EXCITEMENT Thisis a severe formof aggressiveness.Duringthisstage,patientwill be irrational,uncooperative,delusional andassaultive. Etiology โข Organicpsychiatricdisorderslike, delirium, dementia, Wemicke-Korsakoff'spsychosis. โข Otherpsychiatricdisorderslike, schizophrenia, mania, agitateddepression, withdrawal fromalcohol anddrugs, epilepsy,acute stressreaction, panicdisorderand personalitydisorders. Management โข Anexcitedpatientisusuallybroughttiedupwitharope or in chains.The firststepshouldbe to remove the chains.A large proportionof aggressionandviolence isdue tothe patientfeelinghumiliated at beingtiedupinthismanner. โข Talktothe patientandsee ifhe responds.Firmandkindapproachbythe nurse isessential. โข Usuallysedationisgiven.Commondrugsusedare:diazepam10-20mg,IV;haloperidol10-20mg; chlorpromazine 50-100mg IM. โข Once the patientissedated,take careful historyfromrelatives;rule outthe possibilityof organic pathology.Inparticularcheckforhistoryof convulsions,fever,recentintakeof alcohol,fluctuationsof consciousness. โข Carry outcomplete physical examination. โข Sendbloodspecimensforhemoglobin,totalbcellcount,etc. โข Lookforevidenceofdehydrationandmalnutrition.If there issevere dehydration,glucose saline drip may be started. โข Have lessfurniture inthe roomandremove sharpinstruments,ropes,glassitems,ties,strings,match boxes,etc.frompatient'svicinity.
- 2. โข Keepenvironmental stimuli,suchaslightingandnoise levelstoaminimum;assignasingle room;limit interactionwithothers. โข Remove hazardousobjectsandsubstances;cautionthe patientwhenthereispossibilityof an accident. โข Staywiththe patientas hyperactivityincreasestoreduce anxietylevel andfosterafeelingofsecurity. โข Redirectviolentbehaviorwithphysical outletssuchasexercise,outdooractivities. โข Encourage the patientto'talk out' hisaggressive feelings,ratherthanactingthemout. โข If the patientisnot calmedbytalkingdownandrefusesmedication,restraintsmaybecome necessary. โข Followingapplicationof restraints,observepatientevery15minutestoensure thatnutritional and eliminationneedsare met. Alsoobserve foranynumbness,tinglingorcyanosisinthe extremities.Itisimportanttochoose the least restrictive alternativeasfaras possible forthese patients. โข Guidelinesforself-protectionwhenhandling an aggressive patient: โข neversee apotentiallyviolentpersonalone. โข keepacomfortable distance awayfromthepatient(armlength). โข be preparedtomove,a violentpatientcanstrike outsuddenly. โข maintainaclearexitroute forboththe staff andpatient. โข be sure that the patienthasno weaponsinhispossessionbeforeapproachinghim. โข if patientishavingaweaponask himto keepitona table orfloorrather thanfightingwithhimtotake it away. โข keepsomethinglikeapillow,mattressorblanketwrappedaroundarmbetweenyouandthe weapon. โข distractthe patientmomentarilytoremove the weapon(throwingwaterinthe patient'sface,yelling etc). โข giveprescribedantipsychoticmedications