ASBD Workshop​

Sunday 24 March 2024, 1.30pm-4.30pm

​Behavioural emergencies are dangerous, occur in a diversity of individuals and settings, and require prompt control to prevent injury to the patient, staff and others present. ASBD is generally multifactorial – a complex and varied set of clinical presentations that may include components of a general medical or surgical condition (including hypoxia), medication side effects, substance intoxication or withdrawal, a mental health condition or a developmental disorder.

Restrictive interventions including seclusion and physical restraint are not therapeutic and can result in patient morbidity and mortality when performed improperly. They should only be used (within an appropriate legal framework):

1. To prevent imminent and serious harm to the person or others.
2. When all reasonable and less restrictive options have been tried or considered and found to be unsuitable. Management of ASBD requires judicious use of behavioural and pharmacological techniques to reduce the agitated state.

The physician will commonly have to provide some advice around sedation to help to contain the situation and enable further medical evaluation without having a complete diagnostic understanding. However applying sedation guidelines without at least considering aetiology can make things worse.

The evidence base for treatment protocols for ASBD is evolving and most health services have developed guidelines or policy statements to assist management. Protocols differ across jurisdictions in Australia and New Zealand in regard to sedative drugs and dosages and clinical acumen continues to be important in tailoring individual treatment plans.