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Agitation Management in the Emergency Department with Physical Restraints: Where Do These Patients End Up?
Simon, Erin L; Smalley, Courtney M; Muir, McKinsey; Mangira, Caroline Mangira; Pence, Rylee; Wahi-Singh, Bhanu; Delgado, Fernando; Fertel, Baruch S.
Afiliación
  • Simon EL; Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, Ohio.
  • Smalley CM; Cleveland Clinic Emergency Services Institute, Cleveland, Ohio.
  • Muir M; Cleveland Clinic, Patient Quality and Safety, Cleveland, Ohio.
  • Mangira CM; Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, Ohio.
  • Pence R; Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, Ohio.
  • Wahi-Singh B; Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, Ohio.
  • Delgado F; Cleveland Clinic, Patient Quality and Safety, Cleveland, Ohio.
  • Fertel BS; Cleveland Clinic, Patient Quality and Safety, Cleveland, Ohio.
West J Emerg Med ; 24(3): 454-460, 2023 May 05.
Article en En | MEDLINE | ID: mdl-37278796
INTRODUCTION: Agitation is frequently encountered in the emergency department (ED) and can range from psychomotor restlessness to overt aggression and violent behavior. Among all ED patients, 2.6% present with agitation or become agitated during their ED visit. We aimed to determine ED disposition for patients requiring agitation management with physical restraints. METHODS: This was a retrospective cohort of all adult patients who presented to one of 19 EDs in a large integrated healthcare system and received agitation management with physical restraints between January 1, 2018-December 31, 2020. Categorical variables are presented as frequency and percentages, and continuous variables are presented as medians and interquartile range. RESULTS: There were 3,539 patients who had agitation management with physical restraints included in this study. In total 2,076 (58.8%) were admitted to the hospital (95% CI [confidence interval] 0.572-0.605), and of those 81.4% were admitted to a primary medical floor and 18.6% were medically cleared and admitted to a psychiatric unit. Overall, 41.2% were able to be medically cleared and discharged from the ED. Mean age was 40.9 years, 2,140 were male (59.1%), 1,736 were White (50.3%), and 1,527 (43%) were Black. We found 26% had abnormal ethanol, (95% CI 0.245-0.274) and 54.6% had an abnormal toxicology screen (95% CI 0.529-0.562). A significant number were administered a benzodiazepine or antipsychotic in the ED (88.44%) (95% CI 0.874-0.895). CONCLUSION: The majority of patients who had agitation management with physical restraints were admitted to the hospital; of those patients, 81.4% were admitted to a primary medical floor and 18.6% were admitted to a psychiatric unit.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antipsicóticos / Restricción Física Tipo de estudio: Observational_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: West J Emerg Med Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antipsicóticos / Restricción Física Tipo de estudio: Observational_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: West J Emerg Med Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos