De-escalation includes three key areas; prevention and minimisation, planning and specific verbal de-escalation.
De-escalation frequently takes the form of a verbal loop in which the clinician listens to the patient, finds a way to respond that agrees with or validates the patient’s position, and then states what they want the patient to do, eg, accept medication, sit down, etc.
This should include clear instruction as to infection control requirements and PPE e.g. “I understand that this may be scary. Staff are wearing masks and gloves to protect you and others from infection, please sit down”.
The loop repeats as the clinician listens again to the patient’s response. The clinician may have to repeat their message multiple times before it is heard by the patient.
COVID‐19 Acute Severe Behavioural Disturbance Risk Formulation Framework.
Reference: Richmond J S et al.
Verbal De-escalation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup. Western Journal of Emergency Medicine. 2012;XIII(1):17-25.