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 .
Sedation assessment tool to score acute behavioural disturbance in the emergency department.
OBJECTIVE The objective of the study was to evaluate the effectiveness of the  sedation assessment tool ( SAT ) in assessing patient response to treatment for acute behavioural disturbance ( ABD ) . METHODS The SAT is a simplified version of the altered mental status score ( AMSS ) and is a 7-point scale assessing levels of agitation and sedation using only two descriptors . To assess the SAT we firstly compared plots of the SAT and the  AMSS  versus time in patients with ABD recruited to a clinical trial . AMSS were converted to the SAT for this comparison . Second , the sensitivity and specificity were calculated for an increase in the SAT to + 2 or + 3 as a predictor of whether additional sedation was required in a prospect i ve cohort of 138 patients . Third , interrater reliability was assessed using two individuals to score the same patient at two different time points and finally the time to record the score was measured . RESULTS Plots of AMSS and  SAT  for 91 patients in the clinical trial illustrated similar trends in agitation/sedation . Seventeen of 138 patients in the second cohort had an increase in the SAT .  Fifteen of 17 ( 88 % ) received additional sedation . The sensitivity and specificity of the SAT for additional sedation was 100 % ( 95 % CI 75 - 100 % ) and 98 % ( 95 % CI 94 - 100 % ) , respectively . The median time for staff to assign the SAT was 10 s ( range 3 - 15 s ) . Interrater reliability was high with a kappa of 0.87 . CONCLUSION The SAT is a simple , rapid and useful measure of the level of agitation/sedation in patients with ABD . Increases in the score reliably indicated the need for further sedation
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 .