Emergency MedicinePsychiatry
Acute Behavioural Disturbance / Rapid Tranquillisation
RCEM/RCPsych/NICE NG10 — de-escalation, oral options, IM rapid tranquillisation, monitoring, post-event review.
Source: RCEM 2022; RCPsych 2022; NICE NG10
Step 1 of ~6
info
Safety & De-escalation First
Safety of staff and patient paramount — call for help, security, police if armed/imminent risk. Exclude organic causes: hypoglycaemia (BG), hypoxia (SpO₂), head injury, intoxication, sepsis, post-ictal, delirium, encephalitis. Collateral history. De-escalation: calm low-stimulus environment, single named negotiator, validate, offer space and oral medication.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Rivaroxaban (Perioperative VTE Prophylaxis) · Direct Oral Anticoagulant — VTE Prophylaxis Post-Surgery
- Morphine (IV/IM — Anaesthesia/ICU) · Strong Opioid Analgesic
- Metoprolol (IV/Oral — Cardiology) · Beta-Blocker
- Lisinopril (HFrEF / Post-MI) · ACE Inhibitor / HFrEF
- Colchicine (Pericarditis / Post-MI Inflammation) · Pericarditis / Coronary Inflammation
- Clopidogrel (ACS / Post-PCI) · Antiplatelet / ACS
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only. Always apply local guidelines and clinical judgement.