Manejo de paciente agitado ou agressivo

Mantovani, Célia; Migon, Marcelo N.; Alheira, Flávio Valdozende; Del-Ben, Cristina Marta

doi:10.1590/s1516-44462010000600006

Cited by 59 publications

(89 citation statements)

References 29 publications

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“…These patients may have difficulty in recognizing that they are sick and therefore may not accept that they need help. Depending on the degree of agitation, they pose a risk to their own physical integrity and also the physical integrity of health professionals and other patients [11].…”

Section: Category 1 Violence: Fear and Physical And Emotional Aggresmentioning

confidence: 99%

Violence as psychosocial risk in the work of psychiatric nurses and management strategies

Scozzafave¹,

Camelo²,

Soares³

et al. 2017

int arch med

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Objective: To analyze the presence of violence as psychosocial risk from the perception of nurses in a psychiatric hospital, as well as the management strategies implemented to address this risk. Methods:Qualitative study with 25 nurses working in a psychiatric hospital. Data collection was carried out from November 2014 to January 2015 through semi-structured interviews. The data were analyzed and organized into thematic categories following three stages: pre-analysis, exploration of the material and treatment of the results obtained. Participants were identified by the letter "E" and received sequential Arabic numeral numbers, thus guaranteeing the anonymity of the speeches. Thus, they were referenced from E1 to E25. The study was approved by the Research Ethics Committee of the University of São Paulo at Ribeirão Preto College of Nursing, Brazil.Results: Violence exists in the everyday routine of psychiatric nurses, with the presence of scratches, pinches, kicks, pushes, squeezes against the wall, biting, aggression with the use of objects, among others, and the management strategies consist in appeals to the family, the cinema, music, reading, exercise, therapy, religion.

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Section: Category 1 Violence: Fear and Physical And Emotional Aggresmentioning

confidence: 99%

Violence as psychosocial risk in the work of psychiatric nurses and management strategies

Scozzafave¹,

Camelo²,

Soares³

et al. 2017

int arch med

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“…The emergency service team should be properly trained to cope with peculiar situations of agitation and violence. Mantovani (2010) considers some action plans: environmental or organizational management, behavioral or attitudinal management, physical management and pharmacological management. The latter was the focus of this study (4) .…”

Section: Introductionmentioning

confidence: 99%

“…Mantovani (2010) considers some action plans: environmental or organizational management, behavioral or attitudinal management, physical management and pharmacological management. The latter was the focus of this study (4) . In psychiatry, the use of drugs with symptomatic therapeutic efficacy is more common, that is, when the goal of the intervention is to control or minimize the patient's problem(5).…”

Section: Introductionmentioning

confidence: 99%

“…In psychiatry, the use of drugs with symptomatic therapeutic efficacy is more common, that is, when the goal of the intervention is to control or minimize the patient's problem(5). Thus, pharmacological management is used to calm down the patient rapidly, reducing the risk of self and hetero-aggressiveness and the occurrence of side effects, but permitting the continuity of the diagnostic investigation and therapeutic approach, maintaining the patient fully or partially responsive (4) . The psychotropic drugs used in cases of psychiatric symptoms affect the Central Nervous System (CNS) and can selectively relieve pain, reduce fever, suppress disordered movements, induce sleep or awakening, reduce the desire to eat or decrease the trend to vomiting.…”

Section: Introductionmentioning

confidence: 99%

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Potenciais interações medicamentosas em um serviço de urgência psiquiátrica de um hospital geral: análise das primeiras vinte e quatro horas

Oliveira

Zago

Aguiar³

2015

SMAD, Rev. Eletrônica Saúde Mental Álcool Drog. (Ed. port.)

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Medication interaction happens when the power or efficiency of one drug is altered by the presence of another. The medication used during psychiatric emergencies is aimed at reducing and/or putting an end to symptoms related to the behavioral change, almost always symptoms of psychomotor agitation and aggressiveness. The use of multiple drugs is common to increase the potential interaction. The objective in this study was to survey the potential pairs of drug interactions administered at the same time at a psychiatric emergency service of a general hospital during the first twenty-four hours of care. A descriptive, exploratory, documentary, retrospective and quantitative study was The most frequent interaction in the histories analyzed was Haloperidol + Promethazine, totaling 17.7% of all 1,537 pairs of drugs administered at the same time during the research period. The database Drugs® informed that, of all pairs administered during that period, Potenciales interacciones medicamentosas en un servicio de urgencia Psiquiátrica de un hosPital general: análisis de las Primeras veinticuatro horasLa interacción medicamentosa ocurre cuando una droga tiene su potencia o eficiencia alterada por la presencia de otra. La medicación utilizada en las urgencias psiquiátricas visa a disminuir y/o cesar síntomas relacionados a la alteración del comportamiento, casi siempre síntomas de agitación psicomotora y agresividad. Es común la utilización de la polifarmacia para aumento del potencial de interacción. La finalidad del estudio fue levantar las posibles parejas de interacciones medicamentosas administradas a la misma hora en un servicio de urgencia psiquiátrica de un hospital general durante las primeras veinticuatro horas de atención. parejas no fue encontrada cualquiera posibilidad de interacción. La clase de medicamentos de las posibles interacciones que predominó fueron los Benzodiacepinas + Antipsicóticos, asociación comúnmente utilizada en las emergencias psiquiátricas, alertando a la necesidad de monitoreo de los posibles efectos adversos de estos medicamentos. A partir de los hallazgos, fue elaborado un cuadro con los principales cuidados de potenciales interacciones entre medicamentos utilizados en la urgencia psiquiátrica.

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“…Even though rapid tranquilization through pharmacological interventions might be quick and effective [2], medications can induce adverse effects and moreover, involuntary intramuscular medication should be avoided, since it has been experienced by patients as coercive [3].…”

mentioning

confidence: 99%

Using de-escalation techniques to prevent violent behavior in pediatric psychiatric emergencies: It is possible

Croce¹,

Mantovani²

2017

Pediatr Dimensions

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SummaryThe use of de-escalation techniques have been proposed to be effective and are recommended as first line treatments for the management of acutely agitated patients. Even though guidelines for management of agitation in children usually follow the adult guidelines, few have been published on de-escalation of pediatric patients, its practical application and results. We describe the successful management through de-escalation of agitated and potentially violent behavior in an 8 year-old African American male patient, who presented to the emergency department with aggressive behavior. With a strong rapport, patient and provider were able to negotiate together and complete tasks that were labeled improbable by nursing staff. Very little has been published in the scientific literature in this subject, but the emphasis in avoiding coercive methods is clear in adult guidelines. Our approach follows the domains of de-escalation, demonstrating that those domains, can apply to pediatric patients as well.

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Manejo de paciente agitado ou agressivo

Cited by 59 publications

References 29 publications

Violence as psychosocial risk in the work of psychiatric nurses and management strategies

Violence as psychosocial risk in the work of psychiatric nurses and management strategies

Potenciais interações medicamentosas em um serviço de urgência psiquiátrica de um hospital geral: análise das primeiras vinte e quatro horas

Using de-escalation techniques to prevent violent behavior in pediatric psychiatric emergencies: It is possible

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