Management of Acute Agitation in the Emergency Department Non-Pharmacologic Management

Lesson 3 of9

In Progress

Non-Pharmacologic Management

Jimmy October 25, 2021

Therapeutic Goals

The assumption of this presentation is that verbal de-escalation and oral medications have already been attempted if safe to do so!

Overuse of IM medication can damage patient-provider relationships and mask underlying conditions

Things that are helpful…

Ask if willing to take medications by mouth
- Oral disintegrating tablets – olanzapine (Zyprexa Zydis), risperidone (Risperdal M-tab)
Offer food, blankets, water
Listen to what the patient is saying and acknowledge their feelings
Offer optimism and options

De-escalation techniques

Verbal and nonverbal de-escalation techniques
Ten domains of de-escalation that help clinicals take care of agitated patients

10 domains of de-escalation
1. Respect personal space
2. Do not be provocative
3. Establish verbal contact
4. Be concise
5. Identify wants and feelings
6. Listen closely to what the patient is saying
7. Agree or agree to disagree
8. Lay down the law and set clear limits
9. Offer choices and optimism
10. Debrief the patient and staff