Rapid tranquillisation of the acutely disturbed patient

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			Rapid tranquillisation of the acutely disturbed patient
			
					Introduction
				
					Section 1: Aims, policies and training issues
				
					Section 2: Step-by-step approach to RT – step 1 and 2
				
					Section 3 Part 1: Benzodiazepines – determining choice of medication (step 3)
				
					Section 3 Part 2: First generation antipsychotics – determining choice of medication (step 3)
				
					Section 3 Part 3: Second generation antipsychotics – determining choice of medication (step 3)
				
					Section 3 Part 4: Combination medicines – determining choice of medication (step 3)
				
					Section 4: Determining route of administration (step 4)
				
					Section 5: Monitoring after RT (step 5)
				
					Section 6: RT in special circumstances
				
					Section 7: Risk associated with RT and care after RT
				
					Summary

Rapid tranquillisation of the acutely disturbed patientby Dr Stephen Pereira, Dr Deepak Garg and Dr David Branford

Rapid tranquillisation of the acutely disturbed patient Rapid tranquillisation (RT) is defined as:

‘the use of psychotropic medication to control agitation, threatening or destructive psychotic behaviour’ (Ellison et al 1989).

Epidemiological studies show that people with mental disorders are more likely to be violent than community controls and substance misuse greatly increases the risk of violence in people with mental disorders as well as community controls (Davison 2005).

Disturbed or violent behaviour by an individual in an adult in-patient psychiatric setting poses a serious risk to that individual, other patients and staff. Immediate management of such patients is necessary to ensure the safety of other patients and staff and to reduce the patient’s level of distress due to acute agitation. The interventions used should be the minimum required to calm the patient.

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