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 .
Reliability of the Sedation-Agitation Scale between nurses and doctors.
This study determined the inter-rater reliability of the  Sedation-Agitation Scale ( SAS ) when used by staff in a tertiary level general intensive care unit ( ICU ) . The study was design ed to answer the question in the ' real world ' , with minimum patient exclusion criteria , do nurses and doctors rate ICU patient 's sedation levels using the SAS similarly ? A convenient sample of 35 nursing and seven medical staff and a r and omly selected sample of 69 patients were used . A nurse and a doctor rated each patient simultaneously using the SAS , with a systematic five-stage arousal process . The results showed that there was exact agreement between the nurses ' and doctors ' scores in 74 % of assessment s. The weighted kappa finding of 0.82 indicates very good agreement ( reliability ) . The mean SAS scores recorded for nurses ( 2.33+/-1.21 ) and doctors ( 2.36+/-1.35 ) were similar . Intraclass correlations for single measures ( r=.921 , p<.001 ) and average measures ( r=.959 , p<.001 ) indicated individuals who completed multiple ratings did not introduce bias . Where there was a difference between the paired ratings , these were only one level of the SAS away from each other . This research indicates nurses and doctors rate patients ' levels of sedation similarly using the SAS . It also provides support for the use of the instrument in general ICUs outside the USA . Research is now needed to determine the value of the SAS in guiding clinical decision-making related to sedation management
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 .