Heisenberg in the ER: observation appears to reduce involuntary intramuscular injections in a psychiatric emergency service.
BACKGROUND
Chemical restraint is controversial. Appropriate use is ill-defined and chemical restraint may be overutilized. During the period of an unrelated observational study for patients with acute psychomotor agitation in a psychiatric emergency service, we noticed a significant reduction in the number of involuntary intramuscular injections administered.


RESULTS
We observed a 27% decrease (P=.015) in the number of involuntary intramuscular injections in the 3-month observational study period, compared to 3-month periods before and after the study.


CONCLUSIONS
We suggest that the observation process itself may have been beneficial and may have reduced the incidence of unnecessary intramuscular injections.
Damsa
Cristian
C
Service d'Accueil, d'Urgence et de Liaison Psychiatrique, Cantonal Universitary Hospital Geneva, 24, rue Micheli-du-Crest, 1211 Geneva, Switzerland. c.damsa@bluewin.ch <c.damsa@bluewin.ch>
Ikelheimer
Douglas
D
Adam
Eric
E
Maris
Susanne
S
Andreoli
Antonio
A
Lazignac
Coralie
C
Allen
Michael H
MH
D000208:Acute Disease; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006801:Humans; D007273:Injections, Intramuscular / Q000706:statistics & numerical data*; D019370:Observation; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000453:epidemiology*; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D013557:Switzerland; D016896:Treatment Outcome; D014600:Utilization Review / Q000706:statistics & numerical data
D014150:Antipsychotic Agents