Agitation Management in the Emergency Department with Physical Restraints: Where Do These Patients End Up?
West J Emerg Med
; 24(3): 454-460, 2023 May 05.
Article
in En
| MEDLINE
| ID: mdl-37278796
ABSTRACT
INTRODUCTION:
Agitation is frequently encountered in the emergency department (ED) and can range from psychomotor restlessness to overt aggression and violent behavior. Among all ED patients, 2.6% present with agitation or become agitated during their ED visit. We aimed to determine ED disposition for patients requiring agitation management with physical restraints.METHODS:
This was a retrospective cohort of all adult patients who presented to one of 19 EDs in a large integrated healthcare system and received agitation management with physical restraints between January 1, 2018-December 31, 2020. Categorical variables are presented as frequency and percentages, and continuous variables are presented as medians and interquartile range.RESULTS:
There were 3,539 patients who had agitation management with physical restraints included in this study. In total 2,076 (58.8%) were admitted to the hospital (95% CI [confidence interval] 0.572-0.605), and of those 81.4% were admitted to a primary medical floor and 18.6% were medically cleared and admitted to a psychiatric unit. Overall, 41.2% were able to be medically cleared and discharged from the ED. Mean age was 40.9 years, 2,140 were male (59.1%), 1,736 were White (50.3%), and 1,527 (43%) were Black. We found 26% had abnormal ethanol, (95% CI 0.245-0.274) and 54.6% had an abnormal toxicology screen (95% CI 0.529-0.562). A significant number were administered a benzodiazepine or antipsychotic in the ED (88.44%) (95% CI 0.874-0.895).CONCLUSION:
The majority of patients who had agitation management with physical restraints were admitted to the hospital; of those patients, 81.4% were admitted to a primary medical floor and 18.6% were admitted to a psychiatric unit.
Full text:
1
Database:
MEDLINE
Main subject:
Antipsychotic Agents
/
Restraint, Physical
Type of study:
Observational_studies
Language:
En
Journal:
West J Emerg Med
Year:
2023
Type:
Article