ACUTE BEHAViOURAL DISTURBANCE

RCEM 2022 Guideline
Summary of Recommendations
1. All Emergency Departments (EDs) should be familiar with the term Acute Behavioural Disturbance (ABD) and the recognition of potential cases.
2. All EDs should have a locally agreed strategy for the management of cases of ABD.
3. All EDs should have an identified area suitable to provide verbal and environmental de-escalation of ABD cases when required.
4. All EDs should have 24/7 access to sufficient security staff to provide support. These staff should be appropriately trained to provide additional de-escalation and where appropriate, restraint of patients to support clinical care. Where this is not provided, the Trust should clearly describe any alternative provision and how this fulfils the requirements of the Health and Safety at Work Act 1974.
5. Early sedation should be considered in severe cases of ABD, including where prolonged activity or restraint has taken place.
6. In most cases of ABD requiring parenteral sedation, intramuscular ketamine or droperidol are recommended agents.

https://rcem.ac.uk/wp-content/uploads/2022/01/Acute_Behavioural_Disturbance_Final.pdf

Steve Fordham Feb 2022