Updates on the Best Practices For the Management and Treatment of Agitation-View Presentation

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Video Summary

The SMI Advisor webinar, led by Dr. Tony Thrasher and introduced by Dr. Rob Cotez, focused on current best practices for managing and treating agitation. Dr. Thrasher emphasized that agitation should be treated as an emergency, noting its challenges across various healthcare settings. He detailed a blend of cultural, non-pharmacological, and pharmacological strategies to address agitation, urging a shift in perspective from protecting staff to easing patient suffering. Dr. Thrasher underscored that agitation stems from numerous causes, including medical emergencies and psychiatric symptoms, and advocated adopting a comprehensive approach involving all staff members.<br /><br />He highlighted two primary tools for assessing agitation: the BROSET scale, which measures symptom severity over 24 hours, and the Behavioral Activity Rating Scale (BARS), which improves staff feeling of safety and skill. Verbal de-escalation was discussed as a critical skill, where approaches from business, emphasizing empathy and service recovery, could enhance staff-patient interactions. Various pharmacological treatments were reviewed, including traditional options like benzodiazepines and antipsychotics, alongside newer treatments such as Igalmi and the inhaled form of loxapine (Adasuve).<br /><br />Dr. Thrasher encouraged leveraging evidence-based practices from Project Beta, while recognizing the importance of adapting to new pharmacological insights. He noted the potential role of lived experience in de-escalation strategies and emphasized the necessity of addressing systemic cultural shifts in healthcare settings to improve responses to agitation, ultimately aiming to foster safer and more empathetic healthcare environments.

Keywords

agitation management

emergency treatment

non-pharmacological strategies

pharmacological treatments

BROSET scale

Behavioral Activity Rating Scale

verbal de-escalation

Project Beta

cultural shifts

healthcare settings