Mental Health Book

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Agitated Patient

Aka: Agitated Patient, Agitation
  1. See Also
    1. Agitated Delirium
    2. Agitation in Dementia
    3. Violent Behavior
    4. Calming the Agitated Patient
    5. Physical Restraint
    6. Emergency Psychiatric Evaluation
    7. Delirium
  2. Definitions
    1. Agitation
      1. Behavior that is loud, hyperactive, disruptive, threatening or disruptive
    2. Agitated Delirium (Excited Delirium)
      1. Psychomotor Agitation, Delirium and sweating often with Violent Behavior, increased strength, hyperthermia
  3. Precautions: Red Flags for underlying medical causes
    1. See Delirium
    2. Extremes of age (young children, elderly)
    3. Abnormal Vital Signs
    4. Trauma
    5. Delirium
    6. Visual Hallucinations
    7. Neurologic Abnormalities
    8. Acute Intoxication
    9. Unknown Ingestion
    10. Signs of Substance Withdrawal
    11. Serious comorbidities
  4. Causes
    1. See Agitated Delirium
    2. See Altered Mental Status Differential Diagnosis
    3. See Psychosis
    4. See Delirium
    5. Head Trauma
      1. Intracranial Hemorrhage (Acute Subdural Hematoma, Subarachnoid Hemorrhage)
    6. Toxicology
      1. Serotonin Syndrome
      2. Neuroleptic Malignant Syndrome
      3. Sympathomimetic Toxicity
      4. Anticholinergic Toxicity
      5. Alcohol Withdrawal
      6. Benzodiazepine Withdrawal
      7. Stimulant Abuse (e.g. Cocaine, Methamphetamine)
      8. Hallucinogen (PCP)
      9. Wernicke's Encephalopathy (Alcohol Abuse)
    7. Metabolic
      1. Hypoglycemia
      2. Hyperglycemia
      3. Thyrotoxicosis
    8. Thermoregulation
      1. Heat Stroke
      2. Hypothermia
    9. Infection
      1. Encephalitis
      2. Meningitis
      3. Sepsis
    10. Respiratory
      1. Hypoxia
      2. Hypercarbia
    11. Psychiatric Disorder with Psychosis
      1. Major Depression
      2. Bipolar Disorder
      3. Schizophrenia
    12. Dementia
      1. See Agitation in Dementia
      2. Often related to physical discomfort or illness
  5. Exam
    1. Emergency Psychiatric Evaluation
    2. Agitation rating scales
      1. Agitated Behavior Scale
      2. Behavioral Activity Rating Scale
      3. Broset Violence Checklist
  6. Evaluation
    1. See Agitated Delirium
    2. See Altered Mental Status
    3. See Unknown Ingestion
    4. See Psychosis
    5. See Delirium
    6. Evaluate for easily reversible causes
      1. Bedside Glucose (Hypoglycemia)
      2. Hypoxia (Oxygen Saturation)
    7. Diagnostics to consider
      1. Electrocardiogram
      2. Comprehensive Metabolic Panel
      3. Complete Blood Count
      4. Urinalysis
      5. Thyroid Stimulating Hormone
      6. Toxicology Screening
        1. Urine Drug Screen
        2. Blood Alcohol Level
        3. Acetaminophen Level
        4. Salicylate Level
      7. Neurologic Testing
        1. Head CT
        2. Lumbar Puncture
  7. Management
    1. See Agitated Delirium
    2. See Calming the Agitated Patient
    3. See Physical Restraint
  8. References
    1. Roppolo, Klinger, Leaf (2019) Crit Dec Emerg Med 33(2): 3-10

Agitation (C0085631)

Definition (NCI_CTCAE) A disorder characterized by an inability to rest, relax or be still.
Definition (NCI_CTCAE) A disorder characterized by a state of restlessness associated with unpleasant feelings of irritability and tension.
Definition (NCI) A state of restlessness associated with unpleasant feelings of irritability and tension. Causes include pain, stress, fever, alcohol and nicotine withdrawal, cocaine and hallucinogenic drugs use, depression, bipolar disorders, and schizophrenia.
Definition (NCI) An inability to rest, relax, or be still.
Definition (NCI_NCI-GLOSS) A condition in which a person is unable to relax and be still. The person may be very tense and irritable, and become easily annoyed by small things. He or she may be eager to have an argument, and be unwilling to work with caregivers to make the situation better.
Definition (MSH) A feeling of restlessness associated with increased motor activity. This may occur as a manifestation of nervous system drug toxicity or other conditions.
Definition (PSY) State usually characterized by restlessness, anxiety, and anguish.
Concepts Sign or Symptom (T184)
MSH D011595
SnomedCT 162221009, 47295007, 139479003, 139498001, 267071007, 162195000, 224968006, 24199005
LNC LA16474-1
English Agitation, Agitation, Psychomotor, Excitement, Psychomotor, Psychomotor Agitation, Psychomotor Excitement, Restlessness, AGITATION, PSYCHOMOTOR HYPERACTIVITY, PSYCHOMOTOR RESTLESSNESS, RESTLESSNESS MARKED, Restlessness behaviour, Restlessness behavior, demonstrated behavior psychomotor restlessness, psychomotor agitation, psychomotor restlessness (physical finding), psychomotor hyperactivity, abnormal excitement, psychomotor agitation (physical finding), psychomotor hyperactivity (physical finding), demonstrated behavior psychomotor hyperactivity, demonstrated behavior psychomotor agitation, psychomotor restlessness, the behavior demonstrated psychomotor restlessness, the behavior demonstrated psychomotor hyperactivity, the behavior demonstrated psychomotor agitation, Excitement abnormal, Psychomotor hyperactivity, Marked restlessness, Restlessness marked, Psychomotor restlessness, Hyperactivity, Psychomotor, Psychomotor Hyperactivity, Psychomotor Restlessness, Restlessness, Psychomotor, Feeling of Restlessness, Psychomotor Agitation [Disease/Finding], agitate, agitated, restless, agitates, agitated behavior, agitation, Agitated (& symptom) (finding), Agitated (& symptom), Agitated behavior (finding), Agitated - symptom, Agitated, Agitated behavior, Agitated behaviour, Feeling agitated, Unable to keep still, Restless, Psychomotor agitation, Excessive overactivity, Feeling agitated (finding), Increased purposeless goalless activity, Psychomotor agitation (finding), Restlessness (finding), restlessness, Excessive overactivity, NOS, Increased purposeless goalless activity, NOS, Psychomotor agitation, NOS
Portuguese AGITACAO PSICOMOTORA, Agitação pronunciada, Agitação psicomotora, Excitação anormal, Agitado, Nervosismo psicomotor, Inquieto, AGITACAO MARCADA, AGITACAO, HIPERACTIVIDADE PSICOMOTORA, Hiperactividade psicomotora, Irrequietude, Agitação, Agitação Psicomotora, Excitação Psicomotora, Inquietação
Spanish AGITACION PSICOMOTORA, Inquietud acusada, Inquietud psicomotora, Inquietud marcada, Agitación psicomotora, Excitación anormal, Inquieto, Agitado, AGITACION, HIPERACTIVIDAD PSICOMOTORA, INQUIETUD INTENSA, agitación psicomotora, agitación psicomotora (hallazgo), agitación psicomotriz, agitación psicomotriz (hallazgo), agitación (hallazgo), agitación, aumento de la actividad realizada sin un objetivo específico, desazón, hiperactividad excesiva, inquietud, Hiperactividad psicomotora, Agitación, Inquietud, Agitación Psicomotora, Excitación Psicomotora
French Impatiences, Excitation anormale, Agité(e), Agitation marquée, Impatience psychomotrice, Impatient(e), Agitation prononcée, Excitation psychomotrice, AGITATION MARQUEE, AGITATION, HYPERACTIVITE PSYCHOMOTRICE, INSTABILITE PSYCHOMOTRICE, Agitation, Agitation psychomotrice, Hyperactivité psychomotrice, Incapacité à rester en place, Instabilité psychomotrice
Italian Agitazione, Irrequietezza, Eccitazione anormale, Agitazione marcata, Irrequietezza marcata, Agitato, Irrequietezza psicomotoria, Irrequieto, Eccitamento psicomotorio, Iperattività psicomotoria, Agitazione psicomotoria
Dutch geagiteerd, psychomotorische agitatie, rusteloosheid duidelijk, uitgesproken rusteloosheid, opwinding abnormaal, rusteloos, psychomotore rusteloosheid, agitatie, psychomotorische hyperactiviteit, rusteloosheid, Agitatie, psychomotorische, Opwinding, psychomotorische, Psychomotorische agitatie, Rusteloosheid
German deutliche Ruhelosigkeit, psychomotorische Ruhelosigkeit, Ruhelosigkeit deutlich, aufgeregt, ruhelos, psychomotorische Agitiertheit, Erregung anomal, AGITIERTHEIT, PSYCHOMOTORISCHE HYPERAKTIVITAET, PSYCHOMOTORISCHE UNRUHE, UNRUHE AUSGEPRAEGT, Agitiertheit, Unruhe, psychomotorische Hyperaktivitaet, Agitiertheit, psychomotorische, Erregung, psychomotorische, Psychomotorische Agitiertheit, Rastlosigkeit
Japanese 激越, 高度な落ち着きのなさ, 異常興奮, 落ち着きのなさ, 精神運動亢進, 精神運動不穏, ｾｲｼﾝｳﾝﾄﾞｳｺｳｼﾝ, ｹﾞｷｴﾂ, ｲｼﾞｮｳｺｳﾌﾝ, ｵﾁﾂｷﾉﾅｻ, ｺｳﾄﾞﾅｵﾁﾂｷﾉﾅｻ, ｾｲｼﾝｳﾝﾄﾞｳﾌｵﾝ, ｾｲｼﾝｳﾝﾄﾞｳｾｲｹﾞｷｴﾂ, 運動不安, 興奮-精神運動性, 静座不能, 長時正座不能, 落着きのない状態, 激越-精神運動, 坐位不能症, 精神運動性激越, 着席不能, 精神運動興奮, 長時正座不能症, 情動不安, 坐位不能, ソワソワ状態, 不穏状態, 坐位保持不能, 精神運動性興奮, アカシジア
Swedish Rastlöshet
Czech psychomotorický neklid, Zjevný neklid, Neklidný, Agitovaný, Neklid zjevný, Psychomotorický neklid, Neklid, Abnormální rozrušení, Agitovanost, Psychomotorická hyperaktivita, Psychomotorická agitace
Finnish Psykomotorinen agitaatio
Russian VOZBUZHDENIE PSIKHOMOTORNOE, AKATIZIIA, BESPOKOISTVO, PSIKHOMOTORNOE VOZBUZHDENIE, АКАТИЗИЯ, БЕСПОКОЙСТВО, ВОЗБУЖДЕНИЕ ПСИХОМОТОРНОЕ, ПСИХОМОТОРНОЕ ВОЗБУЖДЕНИЕ
Polish Niepokój psychoruchowy, Podniecenie psychoruchowe, Pobudzenie psychomotoryczne, Pobudzenie psychoruchowe
Hungarian Agitatio, Nyugtalan, Kóros izgatottság, Jelzett nyugtalanság, Jelentős nyugtalanság, Psychomotoros hyperactivitas, Nyugtalanság, Psychomotoros nyugtalanság, Psychomotoros agitatio, Agitált
Norwegian Rastløshet, Psykomotorisk agitasjon, Psykomotorisk hyperaktivitet, Psykomotorisk rastløshet
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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