When the client is armed or dangerous: management of violent and difficult clients in primary care

Health care settings and providers are not immune to violent or disruptive behavior by clients or by strangers off the street. Verbal abuse and threats of violence can escalate to physical attacks directed against health care practitioners. This article discusses the management of violent or dangerous patients in the primary care setting. Characteristics of potentially violent patients are reviewed, along with assessment clues useful in predicting violent behavior. Specific interventions to counteract or diffuse a potentially violent situation are proposed.