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Questions and Answers
What is the first step in managing a patient with acute anxiety?
What is the first step in managing a patient with acute anxiety?
- Verbally attempt to diffuse the situation
- Establish safety of staff and patient (correct)
- Search for and treat possible medical causes
- Consider monitoring the 4-lead ECG
What medication may be considered for acute anxiety?
What medication may be considered for acute anxiety?
- Diazepam 5 mg IV every 15 min as needed to a max of 10 mg
- Lorazepam 1 mg SL every 15 min as needed to a max of 4 mg (correct)
- Haloperidol 5 mg IV every 15 min as needed to a max of 10 mg
- Midazolam 5 mg IV every 15 min as needed to a max of 10 mg
What should be done if a patient refuses transport?
What should be done if a patient refuses transport?
- Refer to the disruptive behaviour MCP
- Call OLMC (correct)
- Force the patient to be transported
- Let the patient refuse transport
When should the Adult Combative Behaviour MCP be referred to?
When should the Adult Combative Behaviour MCP be referred to?
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What should be done for a patient with acute anxiety after establishing safety?
What should be done for a patient with acute anxiety after establishing safety?
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Study Notes
Treatment of Aggressive Patient
- Establish safety of staff and patient as the primary concern
- Attempt to verbally diffuse the situation to prevent escalation
- Investigate and treat possible underlying medical causes of the behavior
Pharmacological Intervention
- Consider administering lorazepam 1 mg SL every 15 minutes as needed, up to a maximum of 4 mg, for acute anxiety
- Alternatively, consider midazolam 2.5 mg IV every 15 minutes as needed, up to a maximum of 5 mg
Monitoring and Referral
- Monitor the 4-lead ECG to ensure patient's cardiac stability
- Refer to the Disruptive Behavior Management of Combative Patients (MCP) protocol if the patient requires restraint or is aggressive
- Refer to the Adult Combative Behavior MCP protocol for further guidance
- If the patient refuses transport, it is mandatory to call OLMC for further instruction
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