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Mastering De-escalation Techniques: A Guide for Handling Agitated Patients

Updated: Mar 29

Which De-escalation Techniques Can Staff Use When Faced With An Agitated Patient


In healthcare settings, staff often encounter situations where patients become agitated or distressed, posing challenges to providing effective care. In such instances, the ability to de-escalate tense situations is crucial for maintaining safety and promoting positive outcomes for both patients and staff. Here, we explore several de-escalation techniques that healthcare professionals can employ when faced with an agitated patient.

Mastering De-escalation Techniques: A Guide for Handling Agitated Patients
Mastering De-escalation Techniques: A Guide for Handling Agitated Patients

What Are Signs of Agitated Patients

Recognizing signs of agitation in patients is crucial for healthcare professionals to intervene early and prevent escalation. Here are some common indicators of agitation in patients:


  • Verbal Aggression: Patients may exhibit hostile or threatening language, such as yelling, cursing, or making derogatory remarks towards staff or other patients.

  • Physical Aggression: Agitated patients may become physically aggressive, including gestures like clenching fists, pacing, or making threatening movements towards others.

  • Restlessness: Patients may display restlessness, such as pacing back and forth, fidgeting, or repeatedly changing positions.

  • Elevated Vital Signs: Physiological signs of agitation can include increased heart rate, elevated blood pressure, rapid breathing, and dilated pupils.

  • Irritability: Patients may demonstrate irritability or heightened sensitivity to stimuli, reacting negatively to minor disturbances or perceived slights.

  • Defensive Posture: Agitated patients may adopt a defensive posture, such as crossing their arms, backing away from others, or assuming a defensive stance.

  • Poor Impulse Control: Patients may exhibit impulsive behavior, acting without considering the consequences or exhibiting poor judgment.

  • Agitated Speech Patterns: Speech patterns may become rapid, disjointed, or difficult to understand, reflecting the patient's inner turmoil.

  • Hyperactivity: Some patients may demonstrate hyperactive behavior, such as pacing, tapping, or constantly moving limbs.

  • Emotional Distress: Patients may express feelings of fear, anxiety, frustration, or confusion, indicating emotional distress.


It's essential for healthcare professionals to remain vigilant and observant of these signs, as early recognition allows for prompt intervention and the implementation of de-escalation techniques to prevent further escalation and ensure the safety of both patients and staff.


Which De-escalation Techniques Can Staff Use When Faced With An Agitated Patient


Maintain Calm and Composure: One of the most fundamental principles of de-escalation is for staff to remain calm and composed, even in the face of heightened emotions. Patients often mirror the behavior of those around them, so projecting a sense of calmness can help defuse tension and establish a more relaxed atmosphere.


Active Listening: Actively listening to the patient's concerns and grievances can help validate their feelings and demonstrate empathy. Staff should give the patient their full attention, maintain eye contact, and refrain from interrupting or dismissing their concerns. Reflective listening techniques, such as paraphrasing or summarizing the patient's statements, can also convey understanding and foster rapport.


Use Verbal De-escalation Techniques: Verbal de-escalation involves using language to defuse tension and guide the patient toward a calmer state. Staff should employ non-confrontational language, speak in a calm and soothing tone, and avoid using accusatory or inflammatory words. Offering reassurance and acknowledging the patient's feelings can help alleviate anxiety and build trust.


Set Boundaries and Offer Choices: Establishing clear boundaries with the patient can help prevent escalation and maintain a sense of safety for both parties. Staff should communicate any expectations or limitations calmly and respectfully, using assertive yet non-threatening language. Additionally, offering the patient choices whenever possible can empower them and help restore a sense of control over the situation.


Provide Distraction or Relaxation Techniques: Offering distractions or relaxation techniques can help redirect the patient's focus away from their agitation and promote a sense of relaxation.


This can include engaging in simple activities such as deep breathing exercises, or listening to soothing music. The goal is to help the patient shift their attention away from the source of distress and towards more calming stimuli.


Involve Additional Support if Necessary: In some cases, de-escalating an agitated patient may require the involvement of additional support staff or resources. Staff should be prepared to call for assistance from colleagues trained in crisis intervention or security personnel if the situation escalates beyond their control. It's essential to prioritize the safety of both the patient and staff members at all times.


Follow Up and Provide Support: After successfully de-escalating a situation, staff should follow up with the patient to ensure their ongoing well-being and address any remaining concerns or needs.


Offering additional support resources, such as counseling services or referrals to mental health professionals, can help prevent future escalations and promote long-term recovery.


Mastering de-escalation techniques is a critical skill for healthcare staff when confronted with agitated patients.


Maintaining calmness, actively listening, using verbal techniques, setting boundaries, providing distractions, and seeking additional support when needed, staff can effectively manage challenging situations and ensure the safety and well-being of all involved parties.


Through ongoing training and practice, healthcare professionals can enhance their ability to de-escalate tensions and promote positive outcomes in patient care.


Conflict Resolution Strategies and Self Defense Resources

The Center for Violence Prevention and Self Defense (CVPSD) is a non profit 501(C)(3) with a mission to stop violence by educating at-risk people and empower them with the skills needed to protect themselves by providing online and live training. 


Through workshops and seminars we educate participants about violence prevention and guide them on assessing risk factors while establishing boundaries in relationships. Additionally practical self defense classes equip people with hands on skills and effective strategies to prevent and intervene in cases of assault. CVPSD reaches individuals and communities through partnerships with schools and other nonprofits, community groups, as well as classes for the public.

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