Estrategias para el tratamiento del paciente agitado: trato digno y reducción del riesgo de daños

Abstract

In the context of the profound changes in the fields of psychiatry and mental health, a process of redefinition of mechanical or physical restraint has been developed. From an ethical point of view, physical restraint is a useful and even necessary procedure, as long as it is adjusted to precise clinical indications. It should be established as a last therapeutic resource that is used in extreme situations to control behaviours that involve a high risk for the patient himself, for other people in his or her environment and for health professionals, after all other alternative measures such as the verbal approach or containment, environmental and / or behavioural measures and pharmacological containment have failed.

In some cases, the possibility of applying physical restriction and the use of forced medication is proposed, however, it has been observed that they may become non-therapeutic measures, as well as damage the patient-doctor relationship and be perceived by the patient as an aggression.

It is important that health professionals understand the ethical and therapeutic implications of physical restraint or forced medication, so that they are familiar with both its practice and theory, and to instruct staff on the proper management of the patient avoiding his or her dehumanisation. In the treatment of the agitated patient, it is essential to understand the precise indications for the application of therapeutic measures, since they should not be used punitively and it is expected that they be used as little as possible and only when other interventions have not been effective.