Follow-up

Following management of acute behavioural disturbance, the patient should be allowed to recover in a calm environment with regular monitoring. All patients require a comprehensive clinical assessment after they have recovered to identify the cause, assess management, and to prevent future events; see Assessing a patient with acute behavioural disturbance.

Ensure documentation of management is complete, including nonpharmacological and pharmacological management. If physical restraint was used, document the rationale for its use, the type of restraint used, the patient’s response, monitoring undertaken, the duration of restraint, and any adverse events.

Arrange appropriate medical or psychiatric follow-up, as required. If appropriate, discharge the patient into the care of a responsible adult, with written instructions about resumption of normal activities (eg driving). Sedative drugs can continue to cause significant cognitive impairment for several days following exposure. Advise patients not to drive or operate machinery for at least 3 days after discharge or until review by their general practitioner.

Audit the assessment and management of acute behavioural disturbances for compliance with local protocols, to identify trends and prevent future adverse events.