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What is new in rapid tranquillisation?

Published online by Cambridge University Press:  17 December 2010

Caroline Parker  and
Masum G Khwaja
Caroline Parker*
Affiliation:
Consultant Pharmacist, Adult Mental Health, St Charles' Hospital, Central & North West London NHS Foundation Trust, UK
Masum G Khwaja
Affiliation:
Consultant Psychiatrist and Honorary Senior Lecturer, Central & North West London NHS Foundation Trust, West End Community Mental Health Team, London, UK
*
Correspondence to: Mrs Caroline Parker, Pharmacy Offices, St Charles' Hospital, Exmoor Street, London W10 6DZ. Tel: 0208 206 7361; E-mail: caroline.parker@nhs.net
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Abstract

Giving medicines to quickly calm the severely agitated patient, in order to reduce the risk of imminent and serious violence to self or others, is referred to as rapid tranquillisation (RT).

Despite national guidelines on the management of violence, several Royal College of Psychiatrists guidelines, consensus statements, best practice guidelines, and numerous reviews of the evidence, there is no current consensus as to the first line pharmacological agent in RT.

Over the last few years there have been a number of new medicines for RT, new formulations, and new evidence. The discontinuation of droperidol injection led to more widespread use of haloperidol. The maximum dose of haloperidol has decreased, baseline ECGs are now recommended, and it is no longer licensed for IV administration. These developments have led to changes in RT practice.

In order to safely use the new medicines and new formulations it is imperative that all staff involved in prescribing and administration should be familiar with the practical use of these medicines. This includes methods of preparation and administration, specific side effects and monitoring requirements, as well as their own responsibilities in regard to these medicines.

Keywords

Rapid tranquillisationmedicinesprescribing
Type
Review
Information
Journal of Psychiatric Intensive Care , Volume 7 , Issue 2 , December 2011 , pp. 91 - 101
Copyright
Copyright © NAPICU 2011

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