Articles That May Change Your Practice: Chemical Restraint of Agitated Patients

Abstract

The management of acutely agitated patients represents a challenge in the prehospital and transport setting. Agitated patients are not only a threat to themselves but also to the providers and the transport vehicle in which they travel. There are a variety of techniques that can be used to manage agitated behavior. These include verbal management techniques, physical restraints, pharmacologic interventions, or a combination of these. A drug is considered a restraint when it is used with the intent to manage or restrict the patient's behavior or freedom of movement and is not a standard treatment or dosage for the patient's condition. Russell D. MacDonald, MD, MPH, FCFP, FRCPC, is the medical director at Ornge Transport Medicine; an associate professor at the University of Toronto; and an attending staff member at Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada. He can be reached at [email protected]. Suad Albulushi, MD, ARBEM, OMSB(EM), is a fellow in the clinical track of the emergency medicine fellowship program in the Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.