Q How to manage a violent psychiatric patient?
Management of imminent violence in psychiatric patient is very important. There are various methods to manage violence which are as follows:nNon-coercive methods: The aim is to engage the patient in calming down and dealing with anger or frustration in a non-violent way.nTechniques include de-escalation, time out, increased observation and support, and offeringnmedication with consent, if indicated.nRestraint : If the more collaborative approaches fail or the situation is acutely dangerous, staff have to take immediate action to make themselves, others and the patient safe. This usually involves restraining the patient in some way, i.e. constraining their movement so they are unable to act violently.n1 Geographical restraint essentially involves moving the patient to an environment where they can more safely be managed. n2 Physical restraint: when discussing physical restraint we are usually referring to trained staff using recognized techniques of physical contact to hold a patient and restrict their movement, thus preventing them from causing injury. n3 Chemical Constraint: Ideally, staff should obtain the patients consent to receive any medication that might be appropriate to reduce their level of arousal and prevent violence.n4 However, in some circumstances it is necessary to give rapid tranquillisation. The aim of this is to sedate the patient sufficiently to reduce their immediate suffering and minimise the risk ofn5 violence; it is not to treat the underlying condition.