Rapid tranquillisation of the acutely disturbed patient

Disturbed or violent behaviour by an individual patient in an in-patient psychiatric setting poses a serious risk to that individual, other patients and staff.

Immediate management of such situations is necessary to ensure the safety of other patients and staff and to reduce the patient’s level of distress. Although non-pharmacological and oral pharmacological solutions should be attempted first, sometimes rapid tranquillisation (RT) is required.

National Institute for Health and Care Excellence (NICE) (2015) and British Association for Psychopharmacology (BAP) guidelines (Patel et al, 2018) define rapid tranquillisation as ‘use of medication by the parenteral route (usually intramuscular or, exceptionally, intravenous) if oral medication is not possible or appropriate and urgent sedation with medication is needed’.

The interventions used should be the minimum required to calm the patient.

Learning outcomes:

By the end of this module, you should be able to:

• list the aims of rapid tranquillisation (RT)
• describe non-pharmacological approaches to de-escalate the potentially violent situation
• recognise the step-by-step approach to RT
• demonstrate the use of RT in special patient groups and in special situations
• highlight the risks associated with RT.

Availability

This module is available as part of a CPD eLearning subscription.