Agitation – Quiz

Agitation - Prepared by Dr. Elizabeth Woodward

1

Place the following steps of de-escalation of an agitated patient in the correct order:

Verbal de-escalation, seclusion, physical restraint, chemical restraint

Seclusion, physical restraint, chemical restraint, verbal de-escalation

Verbal de-escalation, chemical restraint, physical restraint

Chemical restraint, physical restraint, seclusion

2

It is a wild night in the ER and the following patients have all become agitated and require a chemical restraint. Which patient should NOT be given a benzodiazepine?

Mrs. A, 42 y.o. F, history of prescription drug abuse, has come to the ER in benzodiazepine withdrawal and has become enraged that there is no rehab bed for her.

Mr. B, 21 y.o.M with schizophrenia, experiencing auditory hallucinations and paranoia, has barricaded himself in his room and is threatening to punch all the nurses who come near him.

Ms. C, 29 y.o. F brought in by police intoxicated after getting in a bar fight, becomes violent with the ER MD when he examines her hand fracture.

Mr. D, 55 y.o. M with chronic alcohol abuse, brought into ER 18 hours ago acutely intoxicated after being found in the park, has been ‘sleeping it off’ but is now awake, shaking and tachycardic, and has become agitated and threatening to staff.

3

Which of the following is NOT one of the 10 domains of verbal de-escalation?

Respect personal space – this decreases fear and aggression

Listen closely – this builds rapport

Identify wants and feelings – this builds rapport

Avoid offering choices – this confuses patients

4

Which of the following antipsychotics is NOT recommended as first line agent for treatment of acute agitation in an emergency department setting?

Quetiapine

Haloperidol

Olanzapine

Risperidone

Ziprasidone

Score Card Legend

This colour indicates the correct answer.

This colour indicates the incorrect answer.

This symbol indicates the answer you have chosen.

This colour indicates there is no question/choice.

Your Score: #/4
">
# 1 2 3 4

Score:

A) "> "> "> ">

B) "> "> "> ">

C) "> "> "> ">

D) "> "> "> ">

E) "> "> "> ">