August 24, 2015

Managing patients with Severe Behavioural Disturbance in Emergency Departments: NSW Government Guidelines

New guidelines released by the NWS Government address the management and initial sedation requirements of patients who present to emergency departments with acute severe behavioural disturbance (ASBD). 

The focus for the guideline is for children, adolescents and adults under 65 years, who are unable to have a medical assessment completed due to ASBD and may require the administration of sedation before initial assessment can occur.

The document is guided by the principles of least restrictive, collaborative, patient centred care and offers guidance on the following aspects of behavioural management and sedation:

1. Assessment of the patient with ASBD in a safe environment

2. Use of de-escalation techniques that focus on engagement of the person with ASBD to allow for assessment

3. Ensuring that legal requirements are adhered to, particularly in relation to the Mental Health Act 2007, the Guardianship Act 1987, The Children and Young Persons (Care and Protection) Act 1998 and the clinician’s duty of care to the patient

4. Sedation of the patient whose behaviour puts them or others at immediate risk of serious harm and which is unable to be contained by other means. There is also reference to physical restraint of the patient if required

5. Post sedation care of the patient including observations and documentation

6. Disposition decisions and transport of the patient from the ED to the most appropriate area for continuation of their care.

Click here for information on Maybo training for emergency department staff

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Click here to view a copy of the Guidelines