TY - JOUR PY - 2023// TI - Agitation management in the emergency department with physical restraints: where do these patients end up? JO - Western journal of emergency medicine A1 - Simon, Erin L. A1 - Smalley, Courtney M. A1 - Muir, McKinsey A1 - Mangira, Caroline Mangira A1 - Pence, Rylee A1 - Wahi-Singh, Bhanu A1 - Delgado, Fernando A1 - Fertel, Baruch S. SP - 454 EP - 460 VL - 24 IS - 3 N2 - INTRODUCTION: Agitation is frequently encountered in the emergency department (ED) and can range from psychomotor restlessness to overt aggression and violent behavior. Among all ED patients, 2.6% present with agitation or become agitated during their ED visit. We aimed to determine ED disposition for patients requiring agitation management with physical restraints.

METHODS: This was a retrospective cohort of all adult patients who presented to one of 19 EDs in a large integrated healthcare system and received agitation management with physical restraints between January 1, 2018-December 31, 2020. Categorical variables are presented as frequency and percentages, and continuous variables are presented as medians and interquartile range.

RESULTS: There were 3,539 patients who had agitation management with physical restraints included in this study. In total 2,076 (58.8%) were admitted to the hospital (95% CI [confidence interval] 0.572-0.605), and of those 81.4% were admitted to a primary medical floor and 18.6% were medically cleared and admitted to a psychiatric unit. Overall, 41.2% were able to be medically cleared and discharged from the ED. Mean age was 40.9 years, 2,140 were male (59.1%), 1,736 were White (50.3%), and 1,527 (43%) were Black. We found 26% had abnormal ethanol, (95% CI 0.245-0.274) and 54.6% had an abnormal toxicology screen (95% CI 0.529-0.562). A significant number were administered a benzodiazepine or antipsychotic in the ED (88.44%) (95% CI 0.874-0.895).

CONCLUSION: The majority of patients who had agitation management with physical restraints were admitted to the hospital; of those patients, 81.4% were admitted to a primary medical floor and 18.6% were admitted to a psychiatric unit.

Language: en

LA - en SN - 1936-900X UR - http://dx.doi.org/10.5811/westjem.59466 ID - ref1 ER -