Managing aggressive and violent patients

Abstract

All healthcare workers, especially general practitioners and staff in emergency departments, are likely to encounter aggression and violence. This behaviour may be caused by a medical illness, a psychiatric illness or drug intoxication or withdrawal. These problems can occur in combination. It is important that a diagnosis is made, but in some cases the patient may need sedation before they can be examined. If non-drug management, such as de-escalation techniques, does not work, a benzodiazepine or antipsychotic can be considered. It is essential that sedated patients are monitored for signs of oversedation. Practice design and policies as well as staff training can help to reduce the risk of violence.