As Different as Day and Night: Managing Acutely Agitated Patients in the Emergency Setting
The emergency department is often the first point of contact for patients experiencing acute agitation due to schizophrenia or bipolar disorder. Yet, the traditional approach of sedation and restraint is increasingly seen as inadequate and potentially harmful. This CME program offers a comprehensive guide for healthcare professionals on the front lines, focusing on evidence-based strategies and novel treatments that prioritize patient safety and autonomy.
- Target Audience: Designed for interprofessional teams, including Emergency Medicine specialists, psychiatrists, NPs, PAs, nurses, and pharmacists.
- Learning Objectives: Learn to recognize unique signs of agitation, differentiate them from other symptoms, integrate best-practice guidelines, and evaluate both injectable and non-injectable therapies.
- Accreditation: 1.25 Interprofessional Continuing Education (IPCE) credits offered through a joint accreditation by ACCME, ACPE, and ANCC.
- Program Highlights: Real-world case studies, expert consensus guidelines, and emerging data on novel treatment options.
- Faculty: Led by Dr. Michael Gooch, an emergency and flight nurse practitioner and Assistant Professor of Nursing at Vanderbilt University.
Program Interview Synopsis:
- Case Study: Dr. Michael Gooch presents a case study featuring Jason Bradshaw, a patient with a history of schizophrenia experiencing acute agitation in the emergency department.
- Initial Assessment: The program discusses the importance of non-confrontational initial assessment and patient autonomy.
- Treatment Options: Various pharmacological options are explored, including first-generation antipsychotics like haloperidol, second-generation antipsychotics like olanzapine, and other agents like lorazepam and ketamine.
- De-escalation Techniques: Emphasis on verbal de-escalation and patient-centered care as the first line of treatment.
- Safety Measures: Discussion on the need for a secure environment for both the patient and healthcare providers, including physical restraints only as a last resort.
- Outcome and Follow-up: Jason is admitted for inpatient services, highlighting the importance of a comprehensive approach that includes case management and long-term planning.
Agitation in schizophrenia and bipolar disorder can escalate rapidly, posing a risk not only to the patient but also to healthcare personnel and families. Understanding the nuances can be the key to effective and humane treatment.
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