The guidance published by the Royal College of Psychiatrists in the document 'Management of Imminet Violence - Clinical practice guidelines to support mental health services'- March 1998 suggests the following: 1. Consider carefully the design of the care environment in which potentially violent individuals are managed in. 2. Consider training staff in methods of de-escalating and coping with violent behaviour. 3.Either an anti-psychotic alone or a benzodiazepine alone should be used if medication is to be used; the oral or IV routes are preferred as absorption from IM route is erratic. "Lorazepam 2-4mg Po, slow IV or IM is very safe and effective" Quote from RCPsych. (1997) - The Association between Antipsychotic Drugs and Sudden Death. 4. That there are risk factors predictive of violent behaviour on which staff could take preventative action:- personal history, clinical variables and situational factors. I use Lorazepam PO or IV generally for chemical restraint. (See also The Maudsley guidelines) Tony Adams Peterborough