Violent patient

What is it about ?

A person who clearly needs medical assistance may at the same time exhibit violent behavior, either towards himself or towards those around him. In such situations, the safety of all involved is the top priority.

Try to identify the cause of the violent behavior. It may be due to:

• an acute physical problem, such as a trauma to the skull or a change in blood sugar (blood sugar) levels;
• a psychiatric condition, such as an acute, aggressively prone psychosis;
• intoxication with alcohol (delirium) or drugs such as amphetamines (speed, ectasy, etc.).

What can you do ?

Maintain your self-control, carry a safety message and let the person know that you want to help them. The situation will often ease on its own if the person can talk about their problem. Always remain calm and patient. Avoid unexpected or threatening gestures and always keep a certain distance. Communication is sometimes difficult or even impossible, and the person is not always ready or able to explain the problem and to collaborate. In this case, it is strongly recommended to seek the help of a doctor or the police.

What can your doctor do?

The doctor will ask the family and loved ones if the abuser has any known problems (physical or mental) and if they are having suicidal thoughts. He will try to calm and calm the person.

If communication fails, medical intervention may be necessary, if necessary under duress. When an aggressive person refuses medication, the police may be considered.
The doctor will usually give an injection of antipsychotics and painkillers. These drugs work fairly quickly. As soon as the situation allows, the doctor will check the person’s blood sugar. He can then possibly decide on a forced admission.

Prevention remains essential. The best predictor of violence is past assault. Arrangements will be made, both with the violent person and with their family and entourage, to guarantee everyone’s safety. Prevention can consist of offering a company, removing weapons and dangerous objects from the home and / or fitting out the home. Temporary admission to a specialized service may be necessary. The procedures for monitoring the person can then be set.

Source

Foreign clinical practice guide ‘Meeting with a violent or threatening patient’ (2000), updated on 08/24/2017 and adapted to the Belgian context on 07/31/2019 – ebpracticenet