Verbal de-escalation techniques have been shown to decrease agitation and reduce the potential for associated violence in the emergency setting .
OBJECTIVE To present the essential guidelines for non-pharmacological management of patients with psychomotor agitation in Brazil .
Prevalence and variation of physical restraint use in acute care settings in the US.
PURPOSE To describe  physical restraint ( PR ) rates and context s in U.S. hospitals . DESIGN This 2003 - 2005 descriptive study was done to measure PR prevalence and context s ( census , gender , age , ventilation status , PR type , and rationale ) at 40 r and omly selected acute care hospitals in six U.S. metropolitan areas . All units except psychiatric , emergency , operative , obstetric , and long-term care were included . METHODS On 18 r and omly selected days between 0500 and 0700 ( 5:00 am and 7:00 am ) , data collectors determined PR use and context s via observation and nurse report . FINDINGS PR prevalence was 50 per 1,000 patient days ( based on 155,412 patient days ) . Preventing disruption of therapy was the chief reason cited . PR rates varied by unit type , with adult ICU rates the highest obtained . Intra- and interinstitutional variation was as high as 10-fold . Ventilator use was strongly associated with PR use . Elderly patients were over-represented among the physically restrained on some units ( e.g. , medical ) but on many unit types ( including most ICUs ) their PR use was consistent with those of other adults . CONCLUSIONS Wide rate variation indicates the need to examine administratively mediated variables and the promotion of unit-based improvement efforts . Anesthetic and sedation practice s have contributed to high variation in ICU PR rates . Determining the types of units to target to achieve improvements in care of older adults requires study of PR sequelae rate by unit type
Verbal de-escalation techniques have been shown to decrease agitation and reduce the potential for associated violence in the emergency setting .
OBJECTIVE To present the essential guidelines for non-pharmacological management of patients with psychomotor agitation in Brazil .