The challenge of psychomotor agitation on clinical practice

Abstract

In this article we will discuss the clinical approach for the management of  psychomotor agitation, a common occurrence in emergency health care settings. The management of psychomotor agitation might be challenging for the health care provider, especially due to the associated risks for the patient and health care team. Thus, the utilization of a stepwise protocol is paramount for the success of this approach. The intervention should start by taking into account three fundamental steps in the management of agitation, such as:  environmental, behavioral, and pharmacological. These steps could be summarized as: addressing or mitigating any underlying medical condition, warranting the safety of patient and health care personnel (environmental),  behavioral management through de-escalation techniques, and as a last resource, the utilization of pharmacological interventions. The confidence of the health care provider in applying these principles is essential in the prevention of somber consequences of psychomotor agitation, such as severe injury and emotional trauma risk for patients and health care staff, and in the appropriate treatment of the general medical condition and/or psychiatric condition that could be the culprit of the agitation.