1. Initial Assessment
Immediate Safety Screening
- Check for immediate danger to patient or others
- Secure environment and remove potential weapons/hazards
- Ensure adequate staff presence
- Activate panic button/security if needed
Rapid Evaluation
- Level of consciousness
- Vital signs
- Evidence of self-harm
- Substance use/intoxication
- Current medications
2. Crisis Stabilization
De-escalation Procedures
- Maintain safe distance
- Use calm, clear communication
- Avoid confrontational stance
- Offer choices when possible
- Set clear boundaries
Medical Intervention
-
Oral Medication Protocol:
- First-line: [medication name and dosage]
- Alternative: [medication name and dosage]
-
Injectable Protocol:
- Emergency medication list
- Administration procedures
3. Disposition Planning
Hospitalization Criteria
- Immediate danger to self/others
- Acute psychosis
- Severe functional impairment
- Failed outpatient management
Transfer Procedures
- Contact receiving facility
- Arrange transportation
- Prepare documentation
- Patient handoff protocol
4. Documentation Requirements
Essential Elements
- Time and date of incident
- Presenting symptoms
- Interventions used
- Disposition decision
- Follow-up plan
5. Staff Responsibilities
Team Roles
- Attending psychiatrist
- Nursing staff
- Security personnel
- Administrative support
6. Emergency Contacts
Priority List
- On-call psychiatrist
- Emergency services (911)
- Crisis response team
- Local psychiatric facilities
Review and update this protocol annually or as needed per facility requirements.