A 42-year-old with schizophrenia is brought by police, shouting and threatening staff. He is diaphoretic, T 37.6°C, HR 132, glucose 5.8 mmol/L, and

Question

A 42-year-old with schizophrenia is brought by police, shouting and threatening staff. He is diaphoretic, T 37.6°C, HR 132, glucose 5.8 mmol/L, and refuses oral medication. Verbal de-escalation and a low-stimulation room have failed. What is the most appropriate initial management?

Accepted Answer

Intramuscular antipsychotic or benzodiazepine with close cardiorespiratory monitoring

Answer

Delay treatment until a psychiatrist personally assesses him

Answer

Immediate discharge once he denies suicidal intent

Answer

Four-point restraint without medication until he becomes exhausted

Answer

Oral psychotherapy-focused intervention in the waiting room

Acute behavioural disturbance — RCPSC EM MCQ

A 42-year-old with schizophrenia is brought by police, shouting and threatening staff. He is diaphoretic, T 37.6°C, HR 132, glucose 5.8 mmol/L, and refuses oral medication. Verbal de-escalation and a low-stimulation room have failed. What is the most appropriate initial management?