Management of the acutely violent patient. 2005

Jorge R Petit
Bureau of Program Services, The New York City Department of Health and Mental Hygiene, New York, NY 10013, USA. jpetit@health.nyc.gov

Violence in the work place is a new but growing problem for our profession. It is likely that at some point a psychiatrist will be confronted with a potentially violent patient or need to assess a violent patient. Understanding predictors and associated factors in violence as well as having a clear and well-defined strategy in approaching and dealing with the violent patient, thus, are crucial. Ensuring patient, staff, and personal safety is the most important aspect in the management of a violent patient. All of the staff must be familiar with management strategies and clear guidelines that are implemented and followed when confronted with a violent patient. The more structured the approach to the violent patient, the less likely a bad outcome will occur. Manipulating one's work environment to maximize safety and understanding how to de-escalate potentially mounting violence are two steps in the approach to the violent patient. Restraint, seclusion, and psychopharmacologic interventions also are important and often are necessary components to the management of the violent patient.

UI MeSH Term Description Entries
D011369 Professional-Patient Relations Interactions between health personnel and patients. Contacting Clients,Pharmacist-Patient Relations,Professional Patient Relationship,Client, Contacting,Clients, Contacting,Contacting Client,Pharmacist Patient Relations,Pharmacist-Patient Relation,Professional Patient Relations,Professional Patient Relationships,Professional-Patient Relation,Relation, Pharmacist-Patient,Relation, Professional-Patient,Relations, Pharmacist-Patient,Relations, Professional-Patient,Relationship, Professional Patient,Relationships, Professional Patient
D011595 Psychomotor Agitation A feeling of restlessness associated with increased motor activity. This may occur as a manifestation of nervous system drug toxicity or other conditions. Agitation, Psychomotor,Akathisia,Excitement, Psychomotor,Restlessness,Psychomotor Hyperactivity,Psychomotor Restlessness,Hyperactivity, Psychomotor,Psychomotor Excitement,Restlessness, Psychomotor
D012149 Restraint, Physical Use of a device for the purpose of controlling movement of all or part of the body. Splinting and casting are FRACTURE FIXATION. Immobilization, Physical,Physical Restraint,Physical Immobilization,Physical Restraints,Restraints, Physical
D004777 Environment The external elements and conditions which surround, influence, and affect the life and development of an organism or population. Environmental Impact,Environmental Impacts,Impact, Environmental,Impacts, Environmental,Environments
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders
D014150 Antipsychotic Agents Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in SCHIZOPHRENIA; senile dementia; transient psychosis following surgery; or MYOCARDIAL INFARCTION; etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus. Antipsychotic,Antipsychotic Agent,Antipsychotic Drug,Antipsychotic Medication,Major Tranquilizer,Neuroleptic,Neuroleptic Agent,Neuroleptic Drug,Neuroleptics,Tranquilizing Agents, Major,Antipsychotic Drugs,Antipsychotic Effect,Antipsychotic Effects,Antipsychotics,Major Tranquilizers,Neuroleptic Agents,Neuroleptic Drugs,Tranquillizing Agents, Major,Agent, Antipsychotic,Agent, Neuroleptic,Drug, Antipsychotic,Drug, Neuroleptic,Effect, Antipsychotic,Major Tranquilizing Agents,Major Tranquillizing Agents,Medication, Antipsychotic,Tranquilizer, Major
D014754 Violence Use of physical force causing or intent to cause harm, injury or abuse. Assaultive Behavior,Atrocities,Behavior, Assaultive,Interpersonal Violence,Physical Assault,Physical Attacks,Structural Violence,Violent Crime,Assault, Physical,Attack, Physical,Attacks, Physical,Crime, Violent,Interpersonal Violences,Physical Assaults,Physical Attack,Violence, Interpersonal,Violence, Structural,Violent Crimes

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