Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation)
Abstract Agitated patients presenting to the emergency department (ED) can escalate to aggressive and violent behaviors with the potential for injury to themselves, ED staff, and others. Agitation is a nonspecific symptom that may be caused by or result in a life‐threatening condition. Project BETA...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12138 |
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| author | Lynn P. Roppolo David W. Morris Fuad Khan Rohini Downs Jeffery Metzger Tiffany Carder Ambrose H. Wong Michael P. Wilson |
| author_facet | Lynn P. Roppolo David W. Morris Fuad Khan Rohini Downs Jeffery Metzger Tiffany Carder Ambrose H. Wong Michael P. Wilson |
| author_sort | Lynn P. Roppolo |
| collection | DOAJ |
| description | Abstract Agitated patients presenting to the emergency department (ED) can escalate to aggressive and violent behaviors with the potential for injury to themselves, ED staff, and others. Agitation is a nonspecific symptom that may be caused by or result in a life‐threatening condition. Project BETA (Best Practices in the Evaluation and Treatment of Agitation) is a compilation of the best evidence and consensus recommendations developed by emergency medicine and psychiatry experts in behavioral emergencies to improve our approach to the acutely agitated patient. These recommendations focus on verbal de‐escalation as a first‐line treatment for agitation; pharmacotherapy that treats the most likely etiology of the agitation; appropriate psychiatric evaluation and treatment of associated medical conditions; and minimization of physical restraint/seclusion. Implementation of Project BETA in the ED can improve our ability to manage a patient's agitation and reduce the number of physical assaults on ED staff. This article summarizes the BETA guidelines and recent supporting literature for managing the acutely agitated patient in the ED followed by a discussion of how a large county hospital integrated these recommendations into daily practice. |
| format | Article |
| id | doaj-art-3d05c3c48ec543ffb5a0403ec9575fb8 |
| institution | DOAJ |
| issn | 2688-1152 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-3d05c3c48ec543ffb5a0403ec9575fb82025-08-20T03:09:46ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522020-10-011589890710.1002/emp2.12138Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation)Lynn P. Roppolo0David W. Morris1Fuad Khan2Rohini Downs3Jeffery Metzger4Tiffany Carder5Ambrose H. Wong6Michael P. Wilson7University of Texas Southwestern Medical Center Department of Emergency Medicine Dallas Texas USAUniversity of Texas Southwestern Medical Center Department of Psychiatry Dallas Texas USAUniversity of Texas Southwestern Medical Center Department of Psychiatry Dallas Texas USAParkland Memorial Hospital Pharmacy Services Dallas Texas USAUniversity of Texas Southwestern Medical Center Department of Emergency Medicine Dallas Texas USAParkland Memorial Hospital Emergency Services Department Dallas Texas USAYale School of Medicine Department of Emergency Medicine New Haven Connecticut USAUniversity of Arkansas for Medical Sciences Department of Emergency Medicine Little Rock Arkansas USAAbstract Agitated patients presenting to the emergency department (ED) can escalate to aggressive and violent behaviors with the potential for injury to themselves, ED staff, and others. Agitation is a nonspecific symptom that may be caused by or result in a life‐threatening condition. Project BETA (Best Practices in the Evaluation and Treatment of Agitation) is a compilation of the best evidence and consensus recommendations developed by emergency medicine and psychiatry experts in behavioral emergencies to improve our approach to the acutely agitated patient. These recommendations focus on verbal de‐escalation as a first‐line treatment for agitation; pharmacotherapy that treats the most likely etiology of the agitation; appropriate psychiatric evaluation and treatment of associated medical conditions; and minimization of physical restraint/seclusion. Implementation of Project BETA in the ED can improve our ability to manage a patient's agitation and reduce the number of physical assaults on ED staff. This article summarizes the BETA guidelines and recent supporting literature for managing the acutely agitated patient in the ED followed by a discussion of how a large county hospital integrated these recommendations into daily practice.https://doi.org/10.1002/emp2.12138agitationphysical assaultProject BETAworkplace violence |
| spellingShingle | Lynn P. Roppolo David W. Morris Fuad Khan Rohini Downs Jeffery Metzger Tiffany Carder Ambrose H. Wong Michael P. Wilson Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation) Journal of the American College of Emergency Physicians Open agitation physical assault Project BETA workplace violence |
| title | Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation) |
| title_full | Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation) |
| title_fullStr | Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation) |
| title_full_unstemmed | Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation) |
| title_short | Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation) |
| title_sort | improving the management of acutely agitated patients in the emergency department through implementation of project beta best practices in the evaluation and treatment of agitation |
| topic | agitation physical assault Project BETA workplace violence |
| url | https://doi.org/10.1002/emp2.12138 |
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