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Management of behavioral emergencies
1Department of Psychiatry, University of Florida College of Medicine, Gainesville, USA.
The American Journal of Emergency Medicine
|May 1, 1995
Summary
Managing behavioral emergencies in emergency departments requires differentiating patient needs. Interventions range from nonpharmacological to maximal pharmacological approaches based on the condition and patient presentation.
Area of Science:
- Emergency Medicine
- Psychiatry
- Behavioral Health
Background:
- Effective management of behaviorally disordered patients in emergency departments is crucial.
- Diagnosis and treatment planning are often complex, with treatment frequently preceding accurate diagnosis.
Purpose of the Study:
- To outline a practical management framework for behavioral emergencies.
- To categorize emergency presentations based on the level of intervention required.
Main Methods:
- A classification system for behavioral emergencies is proposed.
- Interventions are categorized into nonpharmacological, minimal pharmacological, and maximal pharmacological.
Main Results:
- Nonpharmacological interventions are indicated for suicidal states, homicidal states, self-neglect, abuse, and conditions needing organic workup.
- Minimal pharmacological intervention is suitable for adjustment disorder, acute grief, rape/assault, and borderline personality disorder.
- Maximal pharmacological intervention is necessary for assault, agitated psychosis, bipolar disorder exacerbation, schizophrenia exacerbation, brief reactive psychosis, delirium, dementia, substance withdrawal, and violent substance intoxication.
Conclusions:
- Differentiating intervention levels (nonpharmacological, minimal, maximal pharmacological) provides a structured approach to managing behavioral emergencies.
- This framework aids emergency department clinicians in providing timely and appropriate care for diverse behavioral presentations.