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Severe psychomotor agitation — RCPSC EM MCQ

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HardPsychiatric emergenciesSevere psychomotor agitationRCPSC EM

A severely agitated adult is striking walls, cannot engage verbally and is holding a metal object while security maintains distance. What is the most appropriate immediate observation and safety arrangement?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Use a coordinated safety response with continuous multiprofessional observation

The best answer is “Use a coordinated safety response with continuous multiprofessional observation”. An immediate threat requires a coordinated team response that protects the patient, staff and other patients while medical assessment and treatment proceed. Canadian emergency guidance reserves continuous multiprofessional observation for the highest-risk presentations. A remote single observer, intermittent checks, waiting-room placement or removal before medical assessment is inadequate for this level of danger.

Reference: Emergency Care BC: Management of the Agitated Adult in the Emergency Department: https://emergencycarebc.ca/clinical_resource/clinical-summary/management-of-agitated-patient-in-the-emergency-department-adult/