Psychiatric emergency - Aggression

Question 1

Conservative management of aggression?

Answer 1

•	Walk away
•	Listen to patient 
•	Prepare before  no one sits between you and the door
•	Know alarm locations and/or carry a personal alarm
•	De-escalation techniques
o	Invite to sit down
o	Listen to their concerns
o	Offer sympathy/apologise
o	Try and address concerns
•	Restrain if necessary 
•	Low stimulus/seclusion if necessary

Question 2

Medical management of aggression?

Answer 2

Rapid tranquilisation 
o	IM Lorazepam
o	IM Haloperidol and Promethazine 
If one doesn’t work tan use the other 
Need frequent medical examinations and ECGs after

Question 3

What are static factors in the risk assessment of aggression nd violence?

Answer 3

Factors that you can’t change e.g. young male

Question 4

What are dynamic factors?

Answer 4

factors you can change over time, environmental e.g. aggression

Question 5

What psychological tool is used to assess agression?

Answer 5

HCR20

Question 6

What does the HCR20 involve?

Answer 6

• 10 past history factors  History
• 5 present variables  Clinical
• 5 future issues  Risk Management
• 20 questions in total!
• Scored out of 40 (2 marks for each point)

Question 7

What do the results of the HCR20 mean?

Answer 7

• <20 = low risk
• 20-30 = moderate risk
• 30+ = high risk

Question 8

How long is a risk assessment accurate for?

Answer 8

Around 24-48 hours

Question 9

What is battered wife syndrome?

Answer 9

years of chronic abuse and the wife one day snaps, can apply to many situations.

Question 10

What makes a person more dangerous?

Answer 10

If they have no protective factors (nothing to lose)