title: Heisenberg in the ER: observation appears to reduce involuntary intramuscular injections in a psychiatric emergency service.
abstract: 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.
authors.affiliation: 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>
authors.forename: Cristian
authors.initials: C
authors.lastname: Damsa
authors.forename: Douglas
authors.initials: D
authors.lastname: Ikelheimer
authors.forename: Eric
authors.initials: E
authors.lastname: Adam
authors.forename: Susanne
authors.initials: S
authors.lastname: Maris
authors.forename: Antonio
authors.initials: A
authors.lastname: Andreoli
authors.forename: Coralie
authors.initials: C
authors.lastname: Lazignac
authors.forename: Michael H
authors.initials: MH
authors.lastname: Allen
mesh_terms: 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
chemical_list: D014150:Antipsychotic Agents