This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Data supplemnt
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Macpherson, R.
Right arrow Articles by Morgan, S.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Macpherson, R.
Right arrow Articles by Morgan, S.
Advances in Psychiatric Treatment (2005) 11: 404-415
© 2005 The Royal College of Psychiatrists

A growing evidence base for management guidelines

REVISITING... GUIDELINES FOR THE MANAGEMENT OF ACUTELY DISTURBED PSYCHIATRIC PATIENTS

Rob Macpherson, Roland Dix and Sally Morgan

Rob Macpherson is a consultant rehabilitation psychiatrist who works in an assertive outreach team and a number of 24-hour nursed care units in Gloucester (correspondence: Wotton Lawn, Horton Road, Gloucester GL1 3WL, UK. E-mail: rob.macpherson{at}glospart.nhs.uk). He is also Director of the South West Organisation of Psychiatric Training (SWOPT). Roland Dix is a consultant nurse in psychiatric intensive care and secure rehabilitation, a visiting research fellow at the University of the West of England and executive committee member for the National Association of Psychiatric Intensive Care Units. Sally Morgan is a specialist registrar in general adult psychiatry.

We review key recent research and guidance for staff working with acutely disturbed psychiatric patients. Assessment of aggressive patients and their situation should enable full risk assessment, which may ideally involve the use of advance directives. We discuss appropriate use of the Mental Health Act 1983 and consider benefits and adverse effects of rapid tranquillisation. We present a simple protocol for oral or intramuscular rapid tranquillisation. Staff using physical restraint should be properly trained and consider sensitively issues of the patient’s diginity, gender and the most appropriate location for restraint to occur. Simple precautions can improve safety when working with potentially disturbed patients. Staff need support during and after the management of an aggressive incident.