(b) Acting out orally (patient may become defensive, argumentative, and
possibly verbally belligerent).
(c) Acting out physically (patient may lose control and may assault you
by grabbing, striking, and so forth; he may or may not use some type of weapon).
(d) Tension reduction (in this stage patient becomes rational again and
realizes that he has done something wrong).
(2) Although there are no fail-proof predictors of violence, awareness of the
following behaviors may help you anticipate and/or prevent violent episode:
(a)
Past history of violence, violent family life, and/or child abuse.
(b) Body language that includes clenched fists, rigid posture, and/or
tautness (strained or tight).
(c)
Verbalization of hostile threats or anger.
(d)
Increased motor activity.
(e)
Overt aggressive acts.
(f)
Suspicion of others.
c. Procedures for managing an unarmed violent patient are given below.
(1) A violent, agitated patient must be controlled before you attempt to
diagnose or make referral.
(2) Verbal control should be attempted first. The following verbal techniques
are applicable to any situation in which a patient exhibits confused/disoriented, disturbed,
or potentially violent behavior.
(a)
Talk calmly.
(b)
Do not threaten.
(c) Provide reorienting information about who you are, where the patient
is, and how you can help.
(d) Ask the patient questions relating to why he is agitated. This often
gets the person thinking rationally, as well as giving you information. It is often sufficient
to calm someone who is not in a panic anxiety state, and is even sufficient for most
psychotics.
MD0549
5-6