[Psychosocial emergencies—Agitation, aggression and violence in emergency and search and rescue services]

Frank-Gerald B Pajonk, Roberto D'Amelio
Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS 2008, 43 (7): 514-21
A state of agitation occurs in 15-25% of all patients with mental disorder who are seen by pre-hospital emergency physicians (EPs) in the German emergency medical system. Additionally, there is an unknown number of calls due to injury subsequent to violence. Aggression against EPs and paramedics, however, is rare. This paper gives an overview on the models for the onset of aggression, the single stages of agitation and violence, and the stage-dependent steps for de-escalation and crisis intervention in the emergency situation. Action has to be determined but unexcited and, depending on the situation, swift but well coordinated, including psychopharmacotherapy.

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