Niquille M, Gremion C, Welker S, Damsa C
Brigade sanitaire cantonale Département de médecine communautaire HUG, 1211 Genève 14.
Rev Med Suisse. 2007 Aug 15;3(121):1839-46.
Agitation is a behavioral emergency that can have numerous underlying causes, organic as well as psychiatric. The presence of a clinician and well-trained staff determine the quality of care, thus facilitating the dialog with the patient and, if needed, ensuring the safe application of medication and physical restraint. Outside the hospital, an emergency physician is best suited to manage such situations in collaboration with paramedics and police. "De-escalation" without medication or physical restraint should be the preferred end-point of an intervention in agitation. When necessary, medication and restraint should be applied, in order to enable medical evaluation of a patient. Calming without sedation seems the most advised endpoint of intervention, according to expert-opinion.
激越状态是一种行为紧急情况，可能有多种潜在原因，包括器质性和精神性的。临床医生和训练有素的工作人员的在场决定了护理质量，从而促进与患者的对话，并在需要时确保安全用药和使用身体约束措施。在医院外，急诊医生最适合与护理人员和警察合作处理此类情况。不使用药物或身体约束措施的“降级处理”应是激越状态干预的首选目标。必要时，应使用药物和约束措施，以便对患者进行医学评估。根据专家意见，不进行镇静的平静状态似乎是最建议的干预目标。
