A review of the practice and position of monitoring in today’s rapid tranquilisation protocols

Abstract

Background: Rapid tranquilisation (RT) is one of the highest risk clinical procedures currently undertaken by mental health services, yet it is underpinned by a surprisingly weak evidence base. The evidence base is weaker still when applied to post RT monitoring.Aims: To review current clinical monitoring practice contained within adult RT documents in the UK.Method: A review of adult RT documents currently in use in NHS or HSC trusts providing adult mental health services in the UK.Findings: A total of 44 RT documents were examined. A picture of wide ranging practice was observed that prevented us from undertaking a full analysis of the data collected. Even when analysis was confined to the intramuscular route, there were concerning differences between documents in: when monitoring was initiated; what was being monitored; and the frequency and duration of this monitoring.Conclusions and implications for clinical practice: There is a fundamental need for consensus in this high risk practice. The College of Mental Health Pharmacists, Royal College of Nursing and Royal College of Psychiatrists should have a key role in fashioning this consensus in both practice and policy.