title: Waiting room crowding and agitation in a dedicated psychiatric emergency service.
abstract: BACKGROUND
  Emergency department crowding is a growing problem that impacts patient care and safety. The effect of crowding has not been examined in emergency psychiatric services.
  
  
  METHODS
  The association between patient census and use of restraints, seclusion, and anti-agitation medications as needed was examined for 1 month.
  
  
  RESULTS
  A total of 689 patients were seen in 31 days. The average hourly census was 6.8 ± 2.8 (range 0 to 18). There were 33 incidences of seclusion or restraint and an additional 15 instances of medications administered for agitation. The use of seclusion, restraint, or medication for agitation was significantly associated with census (r2 = 0.3, F = 5.47, P = .036).
  
  
  CONCLUSIONS
  Crowding in emergency psychiatric waiting rooms may increase the need for seclusion, restraint, or medications for agitation.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY 40202, USA. rselma01@louisville.edu
authors.forename: Rif S
authors.initials: RS
authors.lastname: El-Mallakh
authors.forename: Amanda
authors.initials: A
authors.lastname: Whiteley
authors.forename: Tanya
authors.initials: T
authors.lastname: Wozniak
authors.forename: McCray
authors.initials: M
authors.lastname: Ashby
authors.forename: Shawn
authors.initials: S
authors.lastname: Brown
authors.forename: Danya
authors.initials: D
authors.lastname: Colbert-Trowel
authors.forename: Tammy
authors.initials: T
authors.lastname: Pennington
authors.forename: Michael
authors.initials: M
authors.lastname: Thompson
authors.forename: Rokeya
authors.initials: R
authors.lastname: Tasnin
authors.forename: Christina L
authors.initials: CL
authors.lastname: Terrell
mesh_terms: D003441:Crowding / Q000523:psychology*; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007629:Kentucky; D010356:Patient Isolation / Q000706:statistics & numerical data*; D011595:Psychomotor Agitation / Q000209:etiology*; D012044:Regression Analysis; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D006993:Hypnotics and Sedatives