Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings
<b>Background/Objectives</b>: The administration of parenteral medications is essential in managing acute arousal within the Behavioral Assessment Unit (BAU) of the emergency department (ED), where timely and effective intervention is critical. This study aims to evaluate current practic...
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MDPI AG
2025-06-01
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| Series: | Clinics and Practice |
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| Online Access: | https://www.mdpi.com/2039-7283/15/6/112 |
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| author | Harshini M. Liyanage Katy Boyce Yiting Gong Theresa Koo Soumitra Das Naveen Thomas |
| author_facet | Harshini M. Liyanage Katy Boyce Yiting Gong Theresa Koo Soumitra Das Naveen Thomas |
| author_sort | Harshini M. Liyanage |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: The administration of parenteral medications is essential in managing acute arousal within the Behavioral Assessment Unit (BAU) of the emergency department (ED), where timely and effective intervention is critical. This study aims to evaluate current practices surrounding the use of parenteral medications for patients with acute agitation, focusing on adherence to protocols, medication safety, documentation accuracy, and patient outcomes. <b>Methods</b>: A retrospective analysis was conducted on 177 cases from December 2023 to February 2024. The study assessed the demographics, diagnoses, treatment protocols, and patient outcomes, with a particular emphasis on the use of parenteral medications such as benzodiazepines and antipsychotics. The relationship between medication administration and involuntary admission, mechanical restraint usage, and patient outcomes was also explored. <b>Results</b>: The majority of patients were aged between 21 and 30 years, and there was a predominance of male patients across both groups. Schizophrenia was the most common diagnosis, with a higher prevalence in the parenteral group (34%) compared to the oral-only group (24%), and personality disorders were more frequent in the parenteral group. Intramuscular (IM) medication administration was strongly associated with the use of mechanical restraint, with patients receiving IM medication being 35 times more likely to require restraint, emphasizing the link between more intensive treatment approaches and behavioral challenges. The most frequently administered medications were diazepam (40.6%) and olanzapine (36.5%), with olanzapine, droperidol, and diazepam most commonly used parenterally. Documentation of physical assessments prior to parenteral administration was present in most cases, though comprehensive evaluations such as ECGs were inconsistently performed. <b>Conclusions</b>: Parenteral medications, including benzodiazepines and antipsychotics, were effective in rapidly stabilizing patients, but the study emphasizes reducing dependency on mechanical restraints. Tailoring treatment to patient characteristics and employing alternative de-escalation strategies can improve safety and align with recovery-oriented care. This study highlights the need for evidence-based practices to optimize care and improve patient outcomes in ED settings. Further research is needed to explore long-term outcomes and refine non-coercive care approaches. |
| format | Article |
| id | doaj-art-95209c6e8f8046339332858f0c5ced39 |
| institution | Kabale University |
| issn | 2039-7283 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj-art-95209c6e8f8046339332858f0c5ced392025-08-20T03:27:21ZengMDPI AGClinics and Practice2039-72832025-06-0115611210.3390/clinpract15060112Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital SettingsHarshini M. Liyanage0Katy Boyce1Yiting Gong2Theresa Koo3Soumitra Das4Naveen Thomas5Western Health, Melbourne 3021, AustraliaWestern Health, Melbourne 3021, AustraliaThe Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne 3010, AustraliaWestern Health, Melbourne 3021, AustraliaWestern Health, Melbourne 3021, AustraliaWestern Health, Melbourne 3021, Australia<b>Background/Objectives</b>: The administration of parenteral medications is essential in managing acute arousal within the Behavioral Assessment Unit (BAU) of the emergency department (ED), where timely and effective intervention is critical. This study aims to evaluate current practices surrounding the use of parenteral medications for patients with acute agitation, focusing on adherence to protocols, medication safety, documentation accuracy, and patient outcomes. <b>Methods</b>: A retrospective analysis was conducted on 177 cases from December 2023 to February 2024. The study assessed the demographics, diagnoses, treatment protocols, and patient outcomes, with a particular emphasis on the use of parenteral medications such as benzodiazepines and antipsychotics. The relationship between medication administration and involuntary admission, mechanical restraint usage, and patient outcomes was also explored. <b>Results</b>: The majority of patients were aged between 21 and 30 years, and there was a predominance of male patients across both groups. Schizophrenia was the most common diagnosis, with a higher prevalence in the parenteral group (34%) compared to the oral-only group (24%), and personality disorders were more frequent in the parenteral group. Intramuscular (IM) medication administration was strongly associated with the use of mechanical restraint, with patients receiving IM medication being 35 times more likely to require restraint, emphasizing the link between more intensive treatment approaches and behavioral challenges. The most frequently administered medications were diazepam (40.6%) and olanzapine (36.5%), with olanzapine, droperidol, and diazepam most commonly used parenterally. Documentation of physical assessments prior to parenteral administration was present in most cases, though comprehensive evaluations such as ECGs were inconsistently performed. <b>Conclusions</b>: Parenteral medications, including benzodiazepines and antipsychotics, were effective in rapidly stabilizing patients, but the study emphasizes reducing dependency on mechanical restraints. Tailoring treatment to patient characteristics and employing alternative de-escalation strategies can improve safety and align with recovery-oriented care. This study highlights the need for evidence-based practices to optimize care and improve patient outcomes in ED settings. Further research is needed to explore long-term outcomes and refine non-coercive care approaches.https://www.mdpi.com/2039-7283/15/6/112acute arousalparenteral medicationsemergency department |
| spellingShingle | Harshini M. Liyanage Katy Boyce Yiting Gong Theresa Koo Soumitra Das Naveen Thomas Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings Clinics and Practice acute arousal parenteral medications emergency department |
| title | Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings |
| title_full | Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings |
| title_fullStr | Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings |
| title_full_unstemmed | Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings |
| title_short | Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings |
| title_sort | administering parenteral medications in managing patients with acute arousal in the behavioral assessment unit of the emergency department in hospital settings |
| topic | acute arousal parenteral medications emergency department |
| url | https://www.mdpi.com/2039-7283/15/6/112 |
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