Managing the Violent Patient, Parts 1 and 2


The videos above on management of the violent patient were produced by psychiatry residents at the The University of Iowa Hospitals and Clinics in 2008 and it’s a hoot. Enjoy this educational and funny presentation. But please remember, even though it was based on material from my chapter on management of the violent patient in Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry, you should adhere to your own institutional policy on how to manage violent patients, whatever the reason for the disruptive behavior. There is a bit of controversy over what some call “restraint-related positional asphyxiation” with some writers finding it implausible from the standpoint of human physiology to organizations providing training for non-violent de-escalation and control of violent behavior who have established policies against using physical restraint [1]. Deaths have been reported in the context of using restraints. Please exercise extreme caution in any situation in which the decision arises to use physical restraints of any kind in volatile situations involving patients who are physically disruptive from any cause. The links below take you to the Crisis Prevention Institute (CPI) website for Nonviolent Crisis Intervention and  a relatively recent article on the adverse effects of physical restraints.

http://www.crisisprevention.com/Specialties/Nonviolent-Crisis-Intervention/Our-Program

http://www.crisisprevention.com/Resources/Knowledge-Base/Positional-Asphyxia

http://ww1.cpa-apc.org:8080/publications/archives/CJP/2003/june/mohr.asp

1.    Glatter, K. and S.B. Karch, Positional asphyxia: inadequate oxygen, or inadequate theory? Forensic Science International, 2004. 141(2-3): p. 201-202.

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