Agitated patient

A few definitions describing agitation

" Feeling of irritability or severe restlessness "

" Exceeding restlessness associated with mental distress "

" Excess motor activity associated with a feeling of inner tension "

Clinical phenomenon with complex pathophysiology

Dysregulations of dopaminergic , serotonergic , noradrenergic and GABAergic systems

Seen in various settings - emergency , hospital wards , institutionalized patients

Other terms that may be used include

acute behavioural disturbance

excited delirium

Evaluation can be challenging and the agitated patient may not be co-operative , consider focused hx based on possible underlying cause.

Try and obtain as much information as you can from computer records , hospital correspondence , discharge letters , investigation results before the encounter : as obtaining history may not always be easy and agitated patients do no want to talk about their history , can retaliate and become violent.

make sure environment is safe

familiarize yourself with exit points , setting

remove any material which can be potentially used as a weapon

have staff present who know the patient and keep a safe distance

only try to obtain vitals when it is safe to do so.

obtaining collateral history from carers / relatives

when did it...