Managing the violent patient in the transition from prehospital care to the emergency department

Proper procedures for the management of violent patients are important to ensure quality patient care as well as safety for prehospital personnel. The article reviews precautions for dispatchers and on-the-scene prehospital personnel in dealing with violent patients and describes specific immobilization techniques, the use of chemical restraints, and indications for the use of on-line physician medical command. Guidelines for ensuring safe transfer of the patient from prehospital care to the care of emergency department personnel are presented. Following the presented guidelines and recommendations should result in proper patient care and ensure the safety of prehospital and emergency department personnel in managing violent or potentially violent patients.