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