Violent patients in the emergency setting

Violent or threatening behavior is a frequent reason for presentation to an emergency department. Patients with aggressive behavior must first be assessed for the possibility of comorbid medical conditions, including acute withdrawal from alcohol or sedatives. Short-term sedation with lorazepam is a safe and effective choice for caging acute agitation. Use of typical neuroleptics may lead to side effects such as akathisia, which may in turn precipitate further agitation. This may be obviated with the introduction of intramuscular preparations of atypical antipsychotics.