With the increasing prevalence of COVID-19 in hospitalised populations, the management of aggression is likely to be a significant issue because of:
Restraint and sedation remain a last resort and only to be used when the risk of injury outweighs the risks of sedation. Refer to guidance for
Management of acute severe behavioural disturbance (ASBD) should be based on local protocols with emphasis on de-escalation strategies and oral medication to reduce the need for restraint and parenteral sedation. Different protocols exist for patients under 18 and over 65.
NSW Health - Guideline for the management of patients with Acute Severe Behavioural Disturbance (ASBD) in Emergency Departments is available as a companion to local protocols.
Out-of-hospital treatment of a mental health patients with a respiratory illness, possibly COVID-19, is a challenging situation. Local organisation-specific procedures and policies should be observed throughout the treatment, transport and handover of the patient to the receiving facility.
Caring for adults with COVID-19 in the Community outlines guidance to assist staff with triage, monitoring and escalation.
These protocols should be augmented by the following specific considerations in patients with known or suspected COVID-19:
COVID‐19 Acute Severe Behavioural Disturbance Risk Formulation Framework.