Relevant bibliographies by topics / Acute Agitation

Academic literature on the topic 'Acute Agitation'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Acute Agitation"

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Wright, P. "Acute agitation: new treatments." European Psychiatry 17 (May 2002): 12. http://dx.doi.org/10.1016/s0924-9338(02)80055-4.

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Childers, Richard, and Gary Vilke. "Ketamine for Acute Agitation." Current Emergency and Hospital Medicine Reports 7, no. 1 (February 6, 2019): 6–13. http://dx.doi.org/10.1007/s40138-019-00177-2.

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Richardson, J. P., and S. Joseph. "Antipsychotics in acute agitation." Psychiatric Bulletin 25, no. 7 (July 2001): 276–77. http://dx.doi.org/10.1192/pb.25.7.276.

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Battaglia, Joseph, Delbert G. Robinson, and Leslie Citrome. "The Treatment of Acute Agitation in Schizophrenia." CNS Spectrums 12, S11 (2007): 1–16. http://dx.doi.org/10.1017/s1092852900026146.

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AbstractAcute agitation is a nonspecific term applied to an array of syndromes and behaviors. It is frequently defined as an increase in psychomotor activity, aggression, disinhibition/impulsivity, and irritable or labile mood. Etiologies of acute agitation include medical disorders, delirium, substance intoxication or withdrawal, psychiatric disorders, and medication side effects. Treatment of acute agitation requires both environmental and pharmacologic intervention. Patients should be calmed with sedating agents early in the course of treatment, allowing for diagnostic tests to take place. Failure to correctly diagnose causes of agitation may lead to delayed treatment for serious conditions, and can even exacerbate agitation.The most common cause of agitation in patients with schizophrenia is psychotic relapse due to medication nonadherence. Pharmacologic treatment options for these patients include lorazepam and antipsychotic agents. Lorazepam causes nonspecific sedation and treats some substance withdrawal, but has little effect on psychosis. First-generation antipsychotics treat psychosis and, at high enough doses, cause sedation, but may induce extrapyramidal side effects (EPS). Some second-generation antipsychotics have been approved for the treatment of agitation in schizophrenia. These agents treat psychosis with a favorable EPS profile, but are comparatively expensive and cause risks such as hypotension. However, avoiding EPS may reduce patients' resistance to antipsychotic treatment.In this expert roundtable supplement, Joseph Battaglia, MD, provides an overview of the definition of acute agitation. Next, Delbert, G. Robinson, MD, outlines evaluation methods for actue agitation. Finally, Leslie Citrome, MD, MPH, reviews interventions for acute and ongoing management of agitation.
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Currier, Glenn W., James C.-Y. Chou, David Feifel, Cynthia A. Bossie, Ibrahim Turkoz, Ramy A. Mahmoud, and Georges M. Gharabawi. "Acute Treatment of Psychotic Agitation." Journal of Clinical Psychiatry 65, no. 3 (March 15, 2004): 386–94. http://dx.doi.org/10.4088/jcp.v65n0315.

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Citrome, Leslie. "Atypical antipsychotics for acute agitation." Postgraduate Medicine 112, no. 6 (December 2002): 85–96. http://dx.doi.org/10.3810/pgm.2002.12.1369.

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Battaglia, John. "Pharmacological Management of Acute Agitation." Drugs 65, no. 9 (2005): 1207–22. http://dx.doi.org/10.2165/00003495-200565090-00003.

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King, Bill, and Glenda Watt. "Dementia in acute units: agitation." Nursing Standard 9, no. 21 (February 15, 1995): 25–27. http://dx.doi.org/10.7748/ns.9.21.25.s36.

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Zimbroff, Dan L. "Pharmacological Control of Acute Agitation." CNS Drugs 22, no. 3 (2008): 199–212. http://dx.doi.org/10.2165/00023210-200822030-00002.

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Benazzi, Franco, Marco Mazzoli, and Emanuela Rossi. "Benzodiazepines and Acute Psychotic Agitation." Canadian Journal of Psychiatry 37, no. 10 (December 1992): 732–33. http://dx.doi.org/10.1177/070674379203701017.

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Dissertations / Theses on the topic "Acute Agitation"

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Strout, Tania Denise Shaffer. "Development of an Agitation Rating Scale for Use with Acute Presentation Behavioral Management Patients." Thesis, Boston College, 2011. http://hdl.handle.net/2345/1839.

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Thesis advisor: June A. Horowitz
Agitation is a distressing set of behaviors frequently observed in emergency department psychiatry patients. Key to developing and evaluating treatment strategies aimed at decreasing and preventing agitation is the availability of a reliable, valid instrument to measure behaviors representative of agitation. Currently, an agitation rating instrument appropriate for use in the emergency setting does not exist and clinicians are left without standard language for communicating about the phenomenon. The Agitation Severity Scale was developed to fill this void using facilitated focus groups to generate an initial item pool. Beginning evidence of content validity was established through a survey of clinical providers and a panel of content experts. The objectives of this methodological study were to: (a) develop an observation-based rating scale to assess the continuum of behaviors known as agitation in adult emergency department patients, and (b) to evaluate the psychometric properties of the newly developed instrument. Psychometric evaluation was conducted using a sample of 270 emergency department psychiatric patients. A 17-item instrument with a standardized Cronbach's alpha coefficient of 0.91 resulted, providing evidence of a high degree of internal consistency reliability. Principle components analysis revealed a 4-component solution accounting for 69% of observed variance. Internal consistency reliability ranged from 0.71 to 0.91 for the scale components. Equivalence reliability was established through the evaluation of Agitation Severity Scores assigned by independent evaluators, r = 0.99, &kappa = 0.98. Construct validity was established through comparison of mean scores for subjects in the highest and lowest scoring quartiles. A statistically significant difference in scores was noted when comparing these groups, t = -17.688, df = 155, p < 0.001. Convergent validity was evaluated by testing the association between Agitation Severity Scores and scores obtained using a well-established instrument, the Overt Agitation Severity Scale. Pearson's correlation coefficient for the associations between the scores ranged from 0.91 to 0.93, indicating a strong, positive relationship between the scores. Finally, the Rasch measurement model was employed to further evaluate the functioning of the instrument. In sum, the Agitation Severity Scale was found to be reliable and valid when used to measure agitation in the emergency setting
Thesis (PhD) — Boston College, 2011
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Graham, Frederick. "Do hospital nurses recognise pain in older agitated patients with cognitive impairment? A descriptive correlational study using virtual simulation." Thesis, Queensland University of Technology, 2021. https://eprints.qut.edu.au/207250/1/Frederick_Graham_Thesis.pdf.

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Agitation and aggression are challenging symptoms commonly experienced by hospitalised cognitively impaired patients. Pain is one well-established cause; however, nurses may not recognise pain-related agitation. This descriptive correlational study examined the clinical decisions of 274 nurses in a virtual simulation of pain-related agitation. Despite high formal knowledge about pain, 95% failed to recognise pain-related agitation and 89% administered antipsychotics. Experiential knowledge, the unconscious but accurate classification of available cues, was identified as crucial to performance. To develop accurate experiential knowledge about pain-related agitation, workplaces may need conditions for deliberate practice, where nurses receive immediate and accurate feedback about their performance.
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Olofsson, Susanne. "Att beskriva och jämföra en expertgrupp och intensivvårdssjuksköterskors överensstämmelse i att detektera delirium hos intuberade, respiratorbehandlade patienter med sedering/analgesi, före och efter en utbildningsintervention : En kvasiexperimentell studie." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-18598.

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The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention. Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change. Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study. It is clear, however, that education and follow-up is needed when new care routines are introduced, and that further studies are needed to clarify whether the CAM-ICU is a valit and reliable instrument to use in clinical practice.
Syftet var att beskriva och jämföra en expertgrupp och intensivvårdssjuksköterskors överensstämmelse i att detektera delirium hos intuberade, respiratorbehandlade patienter med sedering/analgesi, före och efter en utbildningsintervention med instrumentet Confusion assessment method for the intensive care unit (CAM-ICU). Metod: En kvasiexperimentell studie, en grupps pretest – posttest design. Ett bekvämlighetsurval på en allmän intensivvårdsavdelning där inkluderades 17 intensivvårdssjuksköterskor. För att detektera delirium användes instrumentet CAM-ICU, 21 parmätningarna före och 22 efter en utbildningsintervention. Huvudresultat: Resultatet visade att efter utbildningsinterventionen förbättrades sensitiviteten och kappa koefficienten i kännetecken 1 ”akut insättande eller fluktuerande förlopp”, en förbättring som var signifikant. I övriga kännetecken och totalvärden fanns tecken på numerär förbättring och försämring i sensitivitet, specificitet och kappakoefficient men ingen signifikant förändring. Slutsats: Att implementera ett nytt instrument för att detektera delirium i klinisk verksamhet kräver utbildning och uppföljning. Ett litet sample av intensivvårdssjuksköterskor med varierad förmåga att använda det nya instrumentet samt det faktum att patienters status hastigt kan förändras gör det svårt att dra några slutsatser av denna studie. Klart är dock att utbildning och uppföljning behövs när nya vårdrutiner införs, och att ytterligare studier behövs för att klargöra om CAM-ICU är ett valit och reliabelt instrument att använda i klinisk verksamhet.
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Kupeli, N., V. Vickerstaff, N. White, Kathryn Lord, S. Scott, L. Jones, and E. L. Sampson. "Psychometric evaluation of the Cohen-Mansfield Agitation Inventory in an acute general hospital setting." 2017. http://hdl.handle.net/10454/14741.

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Yes
Objectives The Cohen-Mansfield Agitation Inventory (CMAI; (Cohen-Mansfield and Kerin, 1986)) is a well-known tool for assessing agitated behaviours in people with dementia who reside in long-term care. No studies have evaluated the psychometric qualities and factor structure of the CMAI in acute general hospitals, a setting where people with demand may become agitated. Method Longitudinal study investigating pain, agitation and behavioural problems in 230 people with dementia admitted to acute general hospitals in 2011–2012. Cohen-Mansfield Agitation Inventory was completed as part of a battery of assessments including PAINAD to measure pain. Results A nine-item two-factor model of aggressive and nonaggressive behaviours proved to be the best-fitting measurement model in this sample, (χ2 = 96.3, df = 26, p<0.001; BIC [Bayesian Information Criterion] = 4593.06, CFI [Comparative Fit Index] = 0.884, TLI [Tucker Lewis Index] = 0.839, RMSEA [Root Mean Square Error of the Approximation] = 0.108). Although similar to the original factor structure, the new model resulted in the elimination of item 13 (screaming). Validity was confirmed with the shortened CMAI showing similar associations with pain as the original version of the CMAI, in particular the link between aggressive behaviours and pain. Conclusion The factor structure of the CMAI was broadly consistent with the original solution although a large number of items were removed. Scales reflecting physical and verbal aggression were combined to form an Aggressive factor, and physical and verbal nonaggressive behaviours were combined to form the Nonaggressive factor. A shorter, more concise version of the CMAI was developed for use in acute general hospital settings. Copyright © 2017 John Wiley & Sons, Ltd.
Alzheimer's Society and the BUPA Foundation. Grant Number: 131
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Forbes, Mary Therese Potter. "Constructing trust in acute inpatient mental healthcare facilities : the role of physical, social and symbolic environments of care in supporting therapeutic safety." Thesis, 2017. http://hdl.handle.net/10453/116772.

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University of Technology Sydney. Faculty of Health.
This multi-method, multi-case study was a philosophically pragmatic and realist inquiry into how the physical habitat/material environment supports or hinders the creation of therapeutic safety in acute inpatient mental healthcare facilities. The literature review indicated that trust is integral to therapeutic relationships but acts of trust were unlikely without manifest organisers and signifiers of trustworthiness. The Constructing Trust Model that emerged from the review postulated that the Environmental Determinants of Care, comprised of physical, social and symbolic elements, moderated therapeutic trust in the development of safety. The Determinants were incorporated into James Reason’s (1995) Swiss Cheese Model of Accident Causation to illustrate how environments emphasizing surveillance and technical safety do not create therapeutically safe environments but introduce latent error, leading to patient harms such as violence, seclusion and sanctuary harm. Four sites were purposively selected for participation in the study. Initial site visits were made to three newly commissioned facilities and data were collected using key informant interviews, document and artefact analysis. Alterations were made at the fourth site, including: acoustic dampening, wall murals, gardens, increased circulation space, new colour scheme, and new outdoor furniture. Data collection also included focus groups, a safety climate survey, spatial data, incident data and seclusion data. The frequency and duration of seclusion was reduced during renovations. Staff reported consumers found the work a welcome distraction, providing hope that a poor environment would be much improved. On completion staff reported reduced patient agitation, increased patient satisfaction, and fewer incidents of vandalism. Seclusion practices, however, soon reverted. Funding was not provided for changes to address environmental problems known to be linked to seclusion use, that is, overcrowding and social density. Three major findings emerged in the cross-case analysis. Firstly, participants held dichotomous beliefs about safety. I labelled those who viewed safety as arising from the control of concrete hazards requiring custodial environmental designs, ‘Risk Warriors’, and those who considered trusting relationships the precursor to safety, requiring environments signifying care, trustworthiness and refuge, ‘Trust Advocates’. Secondly, at all four facilities decision-makers did not follow the advice of Trust Advocates and introduced unintended risk into the care system, creating the latent conditions for iatrogenic harm. Thirdly, collocation of acute inpatient mental healthcare facilities on general hospital sites encouraged the cultural dominance of Risk Warriors, leading to an over-emphasis on surveillance and the control of risks, to the detriment of trust development strategies and therapeutic safety.
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Books on the topic "Acute Agitation"

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Strenges, Stephen, and Glenn W. Currier. Interventions for Acute Agitation. Edited by Phillip M. Kleespies. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199352722.013.41.

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Given the constant and often increasing risks for violence against mental health professionals, the effective evaluation, management, and treatment of patients with psychotic agitation is of critical importance to ensuring safety. This chapter builds upon several articles of the American Association for Emergency Psychiatry’s Project BETA, which proposes guidelines and best practices for the treatment of agitation. We suggest that clinicians use a tiered, progressive approach to treating agitation in which they attempt less-invasive methods such as verbal de-escalation before drug intervention, when medically appropriate. It is argued that treatment should be proportionate to the severity of agitation, and pharmacological intervention should be used as a last resort.
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Forsyth, Rob, and Richard Newton. Emergencies. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199603633.003.0006.

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Acute agitation 534Emergency management of coma 536Traumatic coma 541Status epilepticus 544Status dystonicus 551Sudden onset visual loss 558The child who suddenly stops walking 559Acute ataxia 572In nearly all situations, environmental, rather than pharmacological, management of acute agitation or psychosis is to be preferred....
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Waldmann, Carl, Neil Soni, and Andrew Rhodes. Neurological disorders. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199229581.003.0022.

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Agitation and confusion 360Status epilepticus 362Meningitis 364Intracerebral haemorrhage 366Subarachnoid haemorrhage 368Ischaemic stroke 370Guillain–Barre syndrome 372Myasthenia gravis 374ICU neuromuscular disorders 376Tetanus 378Botulism 380Neurorehabilitation 382Hyperthermias 384Agitation and confusion are common features in critical illness. Agitation is a symptom or sign of numerous acute and chronic disease states that include pain, anxiety and delirium. Agitation is present in around half of ICU patients, with 15% experiencing severe agitation. Confusion may also be chronic or acute and arise from an overlapping set of pathological processes that includes hypoxia, hypotension, hypoglycaemia and dementia. It is possible to be agitated and not confused, and vice versa. Recognition and treatment of the underlying condition is of utmost importance, rather than treating the symptoms alone....
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Vasilevskis, Eduard E., and E. Wesley Ely. Causes and epidemiology of agitation, confusion, and delirium in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0226.

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Confusion is a non-specific, non-diagnostic term to describe a patient with disorientation, impaired memory, or abnormal thought process. Agitation describes an increased level of psychomotor activity, and anxious or aggressive behaviour. Many agitated patients may also be delirious, yet they only represent a minority of all delirious patients. ICU delirium is an acute cognitive disorder of both consciousness and content of thought. The hallmark of ICU delirium is a fluctuating mental status, inattention, and an altered level of consciousness. Delirium is the end product of a sequence of insults and injury that lead to a common measurable manifestation of end-organ brain injury. It does not have a single aetiology, but often has multiple different and potentially interacting aetiologies. Both non-modifiable and modifiable risk factors play important roles in the development of delirium. Importantly, the new onset of delirium should prompt the physician to investigate the underlying cause. Cognitive impairment and age are among the most important non-modifiable risk factors, whereas administration of benzodiazepines is the greatest. The alpha-2 adrenoceptor agonist dexmedetomidine shows promise as a sedative reducing the risk for delirium when compared with benzodiazepines.
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Fine, Perry G., and Matthew Kestenbaum. Clinical Processes and Symptom Management. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190456900.003.0003.

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This chapter describes what to do when a patient experiences severe anxiety and uncontrolled agitation that negatively affect care and the caregiving environment. Agitation and severe anxiety (panic) represent some of the few true emergency conditions in a hospice setting, so early recognition and prevention are critical. The discussion covers causes in depth, including psychosocial/spiritual and biomedical causes. The chapter details a tactical approach to evaluating and managing severe anxiety and agitation. An example of this is assessing if the patient has an organic brain syndrome due to advancing disease with either local or systemic manifestations and reviewing medications for adverse drug reactions. It then details appropriate processes of care, such as providing pharmacotherapy for acute and recurrent agitation.
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Forsyth, Rob, and Richard Newton. Emergencies. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198784449.003.0006.

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This chapter offers practical information on the management of emergencies in paediatric neurology. A step-by-step guide is given to immediate assessment, differential diagnosis, intervention, investigation, and treatment. The common scenarios addressed are acute agitation; coma; convulsive status epilepticus; status dystonicus; sudden onset visual loss, and the child who suddenly stops walking.
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Crouch, Robert, Alan Charters, Mary Dawood, and Paula Bennett, eds. Mental health emergencies. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199688869.003.0019.

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It is common for patients with mental health problems to present to emergency and urgent care services at times of crisis. Patients with acute distress, agitation, or psychosis can be very difficult to manage in the acute phase of their illness. Emergency departments often have the support of mental health liaison nurses. However, nursing staff still require skills in assessment that enable them to rapidly identify patients with acute problems that may pose a risk to themselves or others. This chapter covers the assessment and management of common mental health emergencies and includes relevant sections within the Mental Health Act.
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Langendonk, Janneke G., and Timothy M. Cox. Porphyrias. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0043.

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The porphyrias are disorders caused by overproduction of metabolites involved in heme biosynthesis. The four acute porphyrias— acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and Doss Porphyria—present with severe abdominal pain, often accompanied by agitation, hypertension, and tachycardia associated with neuropathy and sometimes paralysis. Painful and disabling neurovisceral attacks are due to excess production of the heme precursor ALA (delta-aminolevulinic acid).While 90% of individuals with an inherited defect in heme biosynthesis will never develop symptoms, acute attacks in those affected are provoked by drugs, fasting, and alcohol; in women of reproductive age, they usually occur in the progestagenic phase of the menstrual cycle. All other porphyrias are considered cutaneous porphyrias. They present with blisters or pain on light exposed areas, toxic porphyrins accumulate and give rise to skin symptoms. The cutaneous porphyrias (PCT, EPP, XLEPP, and HEP) do not present with acute neurovisceral attacks (e.g., abdominal pain). However, severe systemic complications can occur.
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Freye, Enno. Management of poisoning by amphetamine or ecstasy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0322.

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While amphetamine and especially methamphetamine (speed) is being misused by all social classes in order to increase stamina, intellectual expansion, endurance, and euphoria, the drug 3,4-methylenedioxy-N-methylamphetamine (MDMA) (ecstasy) is preferentially abused by the younger generation for the feeling of empathy, the touching within, and enhancement of the senses. Acute intoxication differs in regard to their effects on the person. The predominant sympathetic overstimulation after methamphetamine results in cardiovascular and CNS hyperactivity accompanied by agitation and seizures, while tachycardia is a prodrome of fibrillation. The excess hypertonia often leads into myocardial infarction and may even induce cerebral haemorrhage. MDMA intoxication often seen in the emergency department is predominantly characterized by hyperthermia, the most important condition to treat, followed by rhabdomyolysis and acute renal failure. Since there is no specific antidote available, in both cases therapy consists of treatment until the acute effects are gone.
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Mori, Masanori. Clinical Signs of Impending Death in Cancer Patients (DRAFT). Edited by Nathan A. Gray and Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0039.

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In this prospective, longitudinal, cohort study, the authors systematically characterized the frequency, onset, and diagnostic performance of 62 clinical signs for impending death in 357 advanced cancer patients admitted to two acute palliative care units. “Early signs” (e.g., Palliative Performance Scale <20%, Richmond Agitation Sedation Scale ≤–2) had a high frequency over the last 3 days but low positive predictive ratios (LRs) for impending death within 3 days. In contract, “late signs” (e.g., death rattle, respiration with mandibular movement, peripheral cyanosis) had a low frequency but high specificity and high positive LR. In addition, seven neurological signs (e.g., decreased response to verbal stimuli, drooping of nasolabial fold, grunting of vocal cords) and upper gastrointestinal bleeding had high positive LRs for impending death within 3 days. Upon further validation, these signs may assist clinicians in formulating the diagnosis of impending death and patients and families in preparing ahead.
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Book chapters on the topic "Acute Agitation"

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Fok, Henry, Kerry Layne, and Adam Nabeebaccus. "Seizure and Agitation." In 100 Cases in Acute Medicine, 87–89. 2nd ed. Boca Raton: CRC Press, 2022. http://dx.doi.org/10.1201/9781003241171-31.

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Fok, Henry, Kerry Layne, and Adam Nabeebaccus. "Substance Abuse and Agitation." In 100 Cases in Acute Medicine, 233–35. 2nd ed. Boca Raton: CRC Press, 2022. http://dx.doi.org/10.1201/9781003241171-79.

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Simpson, Scott A., and Peter Gooch. "Acute Intoxication and Agitation/Violence." In Cannabis in Psychiatric Practice, 125–32. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04874-6_11.

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Marpuri, Padmapriya, Martin Witkin, and Rajesh R. Tampi. "Safety and Utility of Acute Electroconvulsive Therapy for Agitation and Aggression in Dementia." In Essential Reviews in Geriatric Psychiatry, 241–45. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94960-0_43.

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Luykx, J. J., J. K. Tijdink, C. H. Vinkers, and L. D. de Witte. "Acute agitatie." In Acute psychiatrie, 3–20. Houten: Bohn Stafleu van Loghum, 2022. http://dx.doi.org/10.1007/978-90-368-2801-7_1.

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Rashid, Megan. "Agitation." In Acute Care Casebook, edited by Julie Mayglothling Winkle, 180–83. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190865412.003.0036.

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The case illustrates a classic example of intensive care unit (ICU) delirium, which often goes unrecognized but can adversely affect both morbidity and mortality. The Confusion Assessment Method for the ICU (CAM-ICU) is a validated tool for diagnosing delirium, but it remains a diagnosis of exclusion, and it is important to rule out potentially life-threatening medical causes of altered mental status. Treatment is difficult even with the correct diagnosis, and prevention is key. The ABCDEF bundle (assessing and managing pain, both SAT and SBT, choice of analgesia/sedation, delirium, early mobility, and family engagement) is a tool that identifies high-risk populations, and can help mitigate the prevalence of ICU delirium.
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Green, Christopher J. M. "Agitation." In Acute Care Casebook, edited by Allen Tran, 244–48. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190865412.003.0050.

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Acute agitation is a common issue encountered among patients admitted to inpatient wards, and it has a broad differential diagnosis. When confronted with an agitated inpatient, it is important to consider the underlying etiology before administering any sedatives so that patients receive appropriate management. This case illustrates a possible cause of agitation, alcohol withdrawal, which is potentially life-threatening if not recognized. Discussion focuses on the signs and symptoms that allow alcohol withdrawal to be distinguished from other causes of inpatient agitation, as well as key aspects of management including administration of benzodiazepines and thiamine, and avoidance of medications that lower seizure threshold (e.g., antipsychotics).
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Medzihradsky, Oliver F. "Acute Agitation." In Caring for the Hospitalized Child, 573–79. American Academy of Pediatrics, 2013. http://dx.doi.org/10.1542/9781581108101-part21-ch84.

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Sonnier, Loretta. "Acute Agitation." In Caring for the Hospitalized Child. 2nd ed. American Academy of PediatricsItasca, IL, 2018. http://dx.doi.org/10.1542/9781610021159-99.

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"Case 21 Seizure and agitation." In 100 Cases in Acute Medicine, 49–50. CRC Press, 2012. http://dx.doi.org/10.1201/b13417-23.

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Conference papers on the topic "Acute Agitation"

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O'Connor, Heidi, Nada S. Al-Qadheeb, Bernard Joseph, Alex White, and John W. Devlin. "Agitation During Prolonged Mechanical Ventilation At A Long Term Acute Care Hospital." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a1708.

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Chen, Baitong, Jacek A. Koziel, Myeongseong Lee, Samuel C. O�Brien, Peiyang Li, and Robert C. Brown. "Mitigation of acute H2S and NH3 emissions from swine manure during agitation using pelletized biochar." In 2021 ASABE Annual International Virtual Meeting, July 12-16, 2021. St. Joseph, MI: American Society of Agricultural and Biological Engineers, 2021. http://dx.doi.org/10.13031/aim.202100087.

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Espindola, Mylena Delamare, Thaynara Maria Maran de Souza, Gabriel Loureiro Seleghim Boaventura, and Maria José Martins Maldonado. "Opsoclonus-myoclonus syndrome in pedriatic patient from Campo Grande (MS): case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.131.

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Context: Opsoclonys-myoclonus syndrome (OMS) is a rare neurologic disorder characterized by acute or chronic subcortical myoclonus and cerebellar ataxia at 6 months to 3 years-old children with rates of incidence expressed as 0.18 per 1.000.000 person- year. With nonspecific physiopathology, the only definitive finding is an elevated lymphocyte and positive B-cells count on the cerebrospinal fluid (≥11 cels/mm³) along with 50 to 93% cases reported from the National Pedriatric Myoclun Center (1989-2013) presenting oligoclonal bands. The diagnosis is established by clinical evaluation with exclusion criteria based on the presence of structural central nervous system damage and the aggressive treatment includes immunomodulatory therapy for behavior and cognitive stabilization. Case report: This paper aims to describe a case of a 1-year-old premature pediatrician patient presenting OMS in the absence of fetus distress due to pre- eclampsia condition with long-term hospitalization. After hypotonia, psychomotor agitation and vomit episodes, the patient was referred to Campo Grande (MS) where worsened to globus myoclonus, opsoclonus and nystagmus after 25 days of hospitalization, symptomatology responsive to Propranolol 10mg a day with regression of the clinical and neurological condition. Conclusion:Although OMS is a rare condition with variable prognosis, children appear to respond to pharmacological and non-pharmacological treatment improving the quality of life.
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4

"PV-004 - THE COMPLEXITY OF DUAL PATHOLOGY: REGARDING A CASE REPORT OF SEIZURES." In 24 CONGRESO DE LA SOCIEDAD ESPAÑOLA DE PATOLOGÍA DUAL. SEPD, 2022. http://dx.doi.org/10.17579/abstractbooksepd2022.pv004.

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Abstract:
Objectives: Wernicke's encephalopathy (WE) is a potentially reversible neuropsychiatric emergency caused by thiamine deficiency, whose classical triad consists of confusion, ataxia, and oculomotor dysfunction. The diagnosis is missed in 75-80% of cases and approximately 80% of untreated patients develop Korsakoff Syndrome, whereby recognition of nutritional deficiency or any portion of the triad should prompt treatment. We present a case of a 44-year-old Ukrainian man with suspected background of chronic alcohol abuse and psychiatric history of schizoaffective disorder, who presented with acute onset of confusion, psychomotor agitation, gait ataxia and nystagmus. Anamnesis was hampered by the language barrier and absence of past medical history and patient's alcoholic habits remained unclear. After suspicion of WE it was introduced thiamine and diazepam, with significant improvement. After discontinuation of diazepam, the patient presented with several episodes of tonic-clonic seizures. Starting from this case report, we pretend to discuss the differential diagnosis of seizures in dual pathology. Materials and methods: Clinical records and Pubmed search using the keywords: Wernicke’s Encephalopathy, Seizures, Alcohol, Benzodiazepines. Results and conclusions: Seizures are a common presentation of various conditions associated with alcohol use, whose differential diagnosis is difficult, especially in patients with dubious alcohol consumption. Alcohol abuse is a major precipitant of status epilepticus as seizure threshold is raised by alcohol drinking. Seizures may also occur during alcohol withdrawal for which treatment with benzodiazepines is recommended, however carefully, since both abrupt cessation and high-dose use are critical for the appearance of seizures. Although very rare, WE may also present with seizures, whereby overdiagnosis and overtreatment are preferred to prevent persistent neurocognitive impairments. At discharge the diagnostic discussion prevailed and the patient was medicated for seizures with clinical stabilization. The complexity of psychiatric diagnoses in dual pathology requires a longitudinal assessment for a better understanding of clinical conditions as illustrated here.
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