Acute Behavioural Disturbance SOP

Question 1

Outline the contents of the acute behavioural disturbance SOP

Answer 1

Crucially important that its managed well as it can lead to cardiovascular collapse/arrest

Triad of delirium, agitation and autonomic dysregulation

Can be due to heat or illicit drug use.
Positional asphyxia can cause ineffective ventilation followed by arrest.

Covers:
- Scene management
- Assessing capacity
- Physical restraint
- Chemical restraint
- Temperature management
- Minimum documentations standards

Question 2

How would you maintain safety when responding to a patient with ABD?

Answer 2

• Police
• Body armour
• Consider entry and exit points, don’t block them with bags
• Risk assess before leaving scene with an ABD patient

Question 3

Describe the methods of restraint with respect to patients with ABD

Answer 3

Physical
- Police
- We’re there to mitigate the risks
- No safe period
- Don’t leave people in the prone position

Chemical
- Assess anaesthetic risk
- AAGBI Monitoring
- Ket or Midaz
- PHEA as per indications

Question 4

How would you manage uncontrolled hyperthermia in the context of ABD?

Answer 4

• Chemical restraint/PHEA
• Ice packs, wet sheets/blankets
  Aim for normothermia