[Agitation in prehospital setting: view of emergency physicians]

Abstract

Agitation is a behavioral emergency that can have numerous underlying causes, organic as well as psychiatric. The presence of a clinician and well-trained staff determine the quality of care, thus facilitating the dialog with the patient and, if needed, ensuring the safe application of medication and physical restraint. Outside the hospital, an emergency physician is best suited to manage such situations in collaboration with paramedics and police. "De-escalation" without medication or physical restraint should be the preferred end-point of an intervention in agitation. When necessary, medication and restraint should be applied, in order to enable medical evaluation of a patient. Calming without sedation seems the most advised endpoint of intervention, according to expert-opinion.