Management of violent Patient's in ED ?

[fawnsternurse]

Hi everyone!

I have a generalized question on how you manage violent patients in an emergency dept that does not have its own seperate psychiatric ED.

I am wondering about :

meds

use of restraints

1:1's

Also any involvement from local police depts?

Such as:, handcuffing pts , use of a tazer gun (spelling?) for violent outburts etc

Thank you so much.

:)

[Guest219794]

Taser good, pepper spray bad.

hherrn

[Yin Yang]

We have one doc that will go so far as to intubate them if they present a danger to staff or themselves....we try to warn the patient when he's on that they better straighten up...lol

[nickos]

We have one doc that will go so far as to intubate them if they present a danger to staff or themselves....we try to warn the patient when he's on that they better straighten up...lol

wait...what?? Am I reading it right, that a doc threatens with intubation as a punishment for bad behavior? Whoah...

[Yin Yang]

He doesn't threaten them. We have patients that are truly out of control, detoxing, etc. They do get violent, try to enter other patients room, screaming, and sometimes restraints are not sufficient to control them and still keep them from hurting themselves, even with some chemical intervention to calm them. So yes, he will intubate them and send them to ICU to get them through that period of violence so that they don't get hurt, and none of the staff gets hurt. It also allows the medical staff to care for the other patients that would otherwise be neglected while trying to keep the one patient from hurting themselves. It's not a punishment, but I had one patient that we maxed out on Haldol, benedryl, Ativan, and I don't remember what all else - there was literally nothing else to give him. He was hallucinating, tearing the stretcher apart, and trying to rip stuff off the walls. He was going through DTs. His family was delighted and relieved when we finally intubated him.

[nerdtonurse?, BSN, RN]

Best one I ever "saw" was on Trauma in the ER -- patient had busted out of 4 points a couple of times, and kept ripping out the doc's stitches. The doc sewed they guy's ears to the bed, then completed the repair to the patient's other injuries. No kidding.