Table 1 The main data of the Included studies
From: First line in psychiatric emergency: pre-hospital emergency protocol for mental disorders in Iran
Title | Author/s | Time | Design | Target population | objective | Main points/ result | Sample size |
|---|---|---|---|---|---|---|---|
Emergency psychiatry: physical and chemical restraint in the psychiatric emergency service | Currier GW., et al | 2000 | Review | Patient with psychiatric emergency symptoms | Comparison of benefit and risk of physical restrain in aggressive patient. Comparison of chemical and physical restrain in aggressive patient. Provide recommendations about The correct method of physical restrain | Physical and chemical restraints are important for optimal management of agitated and aggressive patient | – |
Pharmacological management of acute agitation | Battaglia J. | 2005 | Clinical experience | Patient with agitation | Comparison of different medications for Rapid tranquillization of agitated patients in emergencies | The use of ziprasidone (IM) and olanzapine is effective in controlling agitation in patients. | – |
A growing evidence base for management guidelines: Revisiting Guidelines for the Management of Acutely Disturbed Psychiatric Patients | Macpherson R., et al | 2005 | Review | Patient with aggression | Providing recommendations and appropriate drugs to psychiatric management patients with aggression | Four levels of observation of patients at risk of violence were founded. Appropriate medications for rapid tranquilization have been obtained. Appropriate recommendations for aggressive management patients included adjustment of environment and verbal relaxation | – |
The expert consensus guideline series. Treatment of behavioral emergencies | Allen M., et al | 2005 | Expert panel | Psychiatric patient with acute symptoms | Identifying and defining important factors for formulating recommendations and guidelines for agitation control in emergency patients | Defining the following elements: the threshold for emergency interventions, the scope of assessment for varying levels of urgency and cooperation, guiding principles in selecting interventions, and appropriate physical and medication strategies at different levels of diagnostic confidence and for a variety of etiologies and complicating conditions. | 50 experts |
Early psychological intervention in prehospital emergency care systems. | Cunha S., et al | 2009 | RCT | Patient with agitation | assessment of the effect of antipsychotics in agitation control of psychiatric emergency patients | Olanzapine and haloperidol are the best and safe drugs to control patients’ agitation | – |
Atypical antipsychotic medications in the management of disruptive behaviors in children: safety guidelines and recommendations | McKinney C., et al | 2011 | Review | Children and adolescents with Disruptive Behavior | providing guidelines for the use of antipsychotics in children | Studies do not prove the safety of prescribing antipsychotics in children. Further and more detailed studies are needed. | – |
Haloperidol for psychosis-induced aggression or agitation (rapid tranquillization). Cochrane database of systematic reviews | Powney MJ., et al | 2012 | Systematic review | Psychiatric patient with agitation | Assessment effect of haloperidol (oral, IM and IV) in agitated patient | Haloperidol can be the first choice in controlling the restless of psychiatric patients and can be quite redemptive in their treatment | 32 studeis |
The psychopharmacology of agitation: consensus statement of the American Association for Emergency Psychiatry Project BETA Psychopharmacology Workgroup. | Wilson MP., et al | 2012 | Review | Patient with agitation | providing a specific guideline for the management of agitation in different situations | The main treatment for agitation should be based on the most likely cause | – |
Issues in the management of acute agitation: how much current guidelines consider safety? Frontiers in psychiatry | Pacciardi B | 2013 | Review of guideline | Patient with acute agitation | assessment of available and safe drugs for rapid tranquilization in agitative Patient in Emergency | The use of second-generation of antipsychotic is preferred | 11 guidlines |
Intravenous droperidol or olanzapine as an adjunct to midazolam for the acutely agitated patient: a multicenter, randomized, double-blind, placebo-controlled clinical trial | Chan EW., et al | 2013 | RCT | Patient with agitation | to determine the efficacy and safety of intravenous droperidol or olanzapine as an adjunct to intravenous midazolam for rapid patient sedation. | Intravenous droperidol or olanzapine as an adjunct to midazolam is effective and decreases the time to adequate sedation compared with midazolam alone. | 336 patient |
Risk for physical restraint or seclusion in the psychiatric emergency service (PES). General hospital psychiatry | Simpson SA., et al | 2014 | Retrospectively reviewed medical records, nursing logs, and quality assurance data for all adult patient encounters in a PES Over a 12-month period | Adult patient encountered in a PES | describe risk factors associated with patients experiencing physical restraint or seclusion in the psychiatric emergency service (PES) | Physical restraint when needed can be very helpful in calming agitated and violent patients | 5333 patiant |
Assessment and management of agitation in psychiatry: expert consensus. The world journal of biological psychiatry. | Garriga M., et al | 2016 | Systematic review and Delphi and expert panel | Patient with agitation | provide comprehensive recommendations for agitation evaluation and management | physical restrain without over sedation is useful for agitation management. Underline medical illness should be considered. | 124 papers |
Haloperidol plus promethazine for psychosis-induced aggression. Cochrane Database of Systematic Reviews. | Huf G., et al | 2016 | Systematic review | Psychotic patient with aggression | assessment The safety and effect of the combination of promethazine and haloperidol vs haloperidol alone in an agitated patient | This combination is effective and safe but haloperidol alone is better | 6 studies |
Biological treatment of acute agitation or aggression with schizophrenia or bipolar disorder in the inpatient setting. Annals of clinical psychiatry | Correll CU., et al | 2017 | Review | Patient with agitation | summarize the available biological treatment options for patients with schizophrenia or bipolar disorder presenting with acute agitation or aggression in the inpatient setting | The use of second-generation of antipsychotic is preferred. The use of drugs should be based on patient tolerated | – |
Managing acutely aggressive or agitated people in a psychiatric setting: a survey in Lebanon. | Dib JE., et al | 2018 | A survey of clinicians’ opinions and practice was conducted between July and August 2017 at the largest psychiatric hospital in Lebanon | Psychiatric Patient with acute symptoms | Surveying treatments in a psychiatric setting in Lebanon | There was a consistent view that there should first be verbal control, then use of medications, and finally physical restrain of the patient It was found evidence of high family involvement in psychiatric emergency | seven experienced psychiatrists |
Managing agitation associated with schizophrenia and bipolar disorder in the emergency setting. | Zeller SL., et al | 2015 | Review of (BETA) guidelines with the addition of data on new pharmacologic interventions | Patient with agitation | Raise awareness of best practices for the management of agitation in the ED and to consider the role of new pharmacologic interventions in this setting. | (BETA) guidelines address the complete management of agitation Newer modes of delivery that could be useful in rapidly managing agitation include inhaled, buccal/sublingual and intranasal formulations Non-invasive formulations have the potential to improve overall patient experience | – |
Pharmacologic Management of Agitation and Aggression in a Pediatric Emergency Department–A Retrospective Cohort Study. | Kendrick JG., et al | 2018 | Retrospective observational study | Patients less than 20 years of age with agitation and aggretion | To describe medication utilization in the management of agitation and aggression in a pediatric ED and to assess the safety of their use. | Benzodiazepine and antipsychotic drug therapy for acute agitation and aggression in children appears to be safe and well tolerated | 120 patient |