Impact of verbal de-escalation in psychomotor agitation in emergency departments

Abstract

Objective: to evaluate the efficacy of verbal de-escalation in order to avoid mechanical restraint. Material and methods: a literature review was carried out in the PubMed database of scientific articles in English and Spanish published in the last five years. The total result of the literature search was 283 articles. After reviewing the title and abstract, 245 articles were selected. After full reading, 19 scientific articles were selected. Results: training in verbal de-escalation improves the therapeutic relationship, reduces psychomotor agitation and optimizes health outcomes. It also increases emergency staff’s perception of control and fosters more effective and efficient communication, strengthening the functioning of the service. Discussion: psychomotor agitation may be present in anyone requiring urgent care, since it entails a sense of loss of control that may even worsen the reason for consultation. If, in addition, the patient has an underlying psychiatric illness, this could act as the trigger for agitation. For this reason, verbal de-escalation by emergency staff establishes a good therapeutic relationship, giving the patient a sense of calm and preventing an escalation of psychomotor agitation. Recommendations: training in verbal restraint should be considered from the early stages of education, including it as part of the teaching plan of the different university health degrees.