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        Scarcity of evidence base on management of acutely disturbed patients
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Brown et al give a useful insight into the practice at seven intensive care units all over the country. 1

Their results show that 22% of patients were given rapid tranquillisation using the intramuscular route and 68% were not given any rapid tranquillisation medication at all.

The results table is confusing and the numbers do not add up; 3% appear not to have been given any medication at all, which causes concerns about the referral process to psychiatric intensive care units (PICUs) and whether patients were appropriately placed.

The study does not clarify the legal status of the patients and does not throw any light on the level of aggression of the patients in PICUs.

The most common diagnosis was schizophrenia/schizoaffective disorder (54%), followed by mania (19%) and substance misuse (8%). The diagnosis for 19% of patients has not been provided in the study.

1 Brown, S, Chhina, N, Dye, S. Use of psychotropic medication in seven English psychiatric intensive care units. Psychiatrist 2010; 34: 130–5.