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Management of the acutely agitated patient in a remote location

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A consensus statement from Australian aeromedical retrieval services

In this article, we summarise a new consensus statement from Australian aeromedical retrieval services that provides an expert opinion on the assessment and management of acutely agitated patients in remote locations. It also outlines recommendations for patients who require aeromedical evacuation to allow for inpatient medical care, high-level psychiatric care and admission, which are usually only available in regional centres and major cities. The full consensus statement is available on the Royal Flying Doctor Service website.*

Why this consensus statement is needed

Assessing and managing an acutely agitated patient in a remote location with limited resources requires adaptation of usual hospital-based procedures. There are no existing standard or evidence-based guidelines for this situation. Where remote locations have a health service at all, it is generally a small community health centre with limited facilities, staffed by nurses with telehealth support and a regular visiting medical practitioner. These clinics are not staffed after hours, except for emergencies. Thus, even a single presentation of a psychotic or suicidal patient places great strain on the local resources, especially if the patient requires supervision and restraint after hours. Legislative requirements of the relevant mental health act for voluntary versus involuntary treatment…