Psychopharmacology and Psychiatry Updates Beyond Restraints: De-Escalation in Behavioral Emergencies
Jan 11, 2025
Dr. Scott Zeller, an expert in emergency psychiatry and past president of the American Association for Emergency Psychiatry, reveals transformative insights on managing agitation. He emphasizes the significant drawbacks of using physical restraints, which can extend emergency department stays by four hours. Dr. Zeller introduces essential verbal de-escalation techniques, stressing the power of calm communication and the '10 de-escalation commandments' to improve outcomes. His evidence-based approach aims to enhance patient safety and care in crisis situations.
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Restraints Prolong ED Stay
- Physical restraints add an average of four hours to a patient's emergency department stay.
- This increased time results in more blocked bed space and a potentially traumatizing experience for patients.
Prioritize Verbal De-escalation
- Attempt verbal de-escalation first to avoid restraints and heavy sedation in most cases.
- Spending a few minutes calming a patient can save staff hours and reduce injury risk.
Avoid Restraints for Humane Care
- Avoiding restraints is more humane, ethical, and reduces trauma for patients.
- Psychiatric facilities often refuse patients currently in restraints, complicating transfers.