title: A new clinical guideline to improve sedation safety in patients transferred under the Mental Health Act from remote parts of Western Australia.
abstract: OBJECTIVE
  Clinicians dealing with referrals under the Mental Health Act in rural and remote parts of Australia face the difficult task of providing safe sedation whilst transferring the patient to an appropriate authorized facility. This paper reviews the efforts to overcome these challenges in the remote north-west of Australia.
  
  
  METHODS
  Senior medical staff undertook a review of sedation practice in the region. A search was made of the medical literature to determine whether evidence based treatment may exist elsewhere and this information was used in conjunction with consensus opinion to devise a new guideline.
  
  
  RESULTS
  Scant literature exists in the field of sedation and aeronautical evacuation of patients with acute mental health presentations in remote areas. Issues and challenges were identified and a new clinical guideline based on local expert consensus of good practice was developed.
  
  
  CONCLUSIONS
  Standardizing the approach to managing agitated patients who are transferred under the Mental Health Act is essential in order to mitigate medical morbidity that may arise from sedation related complications. The sedation guideline developed by our service has been well received by staff, seems practical and feasible to implement and has the potential to reduce sedation related morbidity.
authors.affiliation: Regional Psychiatrist, Kimberley Mental Health and Drug Service, Broome, WA and; Associate Professor, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, WA, Australia siva.bala@health.wa.gov.au.
authors.forename: Sivasankaran
authors.initials: S
authors.lastname: Balaratnasingam
mesh_terms: D016292:Procedural Sedation / Q000379:methods / Q000592:standards*; D006801:Humans; D008605:Mental Health Services / Q000331:legislation & jurisprudence / Q000592:standards*; D061214:Patient Safety / Q000592:standards*; D010360:Patient Transfer / Q000379:methods / Q000592:standards*; D019035:Rural Health Services / Q000592:standards*; D014904:Western Australia
keywords: Mental Health Act; air evacuation; remote; rural; sedation guideline