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Restraint should be last resort for violent behaviour

BMJ 2005; 330 doi: (Published 24 February 2005) Cite this as: BMJ 2005;330:438
  1. Susan Mayor
  1. London

    Rapid tranquillisation and physical restraint should be considered for use in patients with disturbed or violent behaviour only when other strategies have failed, say guidelines published this week for the NHS in England and Wales.

    The guidance recommends that short term measures for managing disturbed or violent behaviour in psychiatric inpatient settings and accident and emergency departments should be based on comprehensive risk assessment and risk management. All mental health service providers should ensure that their services have a full risk management strategy for assessing risk and preventing violence. This should include measures to calm down a potentially violent situation and intervene safely when violence occurs.

    Rapid tranquillisation, physical restraint, and seclusion should be considered only after these measures have failed to calm the service user, the guidance warns. The intervention selected must be a reasonable and proportionate response to the risk posed by …

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