Wednesday, January 31, 2018

A violent patient in ICU

Q: A violent patient in ICU with a psychiatric disorder or drug/alcohol withdrawal should be asked directly: "Do you feel like hurting yourself or others?"

A) True
B) False

Answer: True

It is both helpful and respectful to have an honest and non-threatening behavior towards a patient who tends toward violence. Addressing violence directly helps!

Also, many other non-pharmacological recommendations may help like friendly gestures,  avoiding direct eye contact, not to approach the patient from behind,  standing at least two arm's lengths away, avoiding argument or giving commands.


1. Hill S, Petit J. The violent patient. Emerg Med Clin North Am 2000; 18:301. 

2. Richmond JS, Berlin JS, Fishkind AB, et al. Verbal De-escalation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup. West J Emerg Med 2012; 13:17.

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