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Introduction to Rapid Tranquilisation (RT)

Acute behavioural disturbance can occur in the context of psychiatric illness, substance misuse, personality disorder and secondary to underlying medical conditions. The behaviour is often driven by psychotic beliefs, agitation, fear, anger and complex emotions. Rapid tranquilisation, also known as chemical restraint, refers to a pharmacological strategy for the management of patients who are exhibiting disturbed or violent behaviour. It is the appropriate use of medication to manage violent behaviour safely and effectively. The aim of the intervention is an emergency measure to quickly calm a patient down and reduce the risk of further violence and harm to themselves or others rather than to treat any underlying psychiatric illness or medical cause. It should not be resorted to routinely.

The use of drugs to aid a patient to calm down is not without risks and can be distressing for patients. As such it should be used in a way that ensures the safety of patients, relatives and staff, and maintains their dignity and respect. It is essential that alternative strategies are considered prior to the use of medication for rapid tranquilisation, including de-escalation methods, restrictive interventions, staff training and post-tranquilisation debrief and review.

The guidelines on pharmacological treatment contained within this policy have been produced in response to the National Institute for Clinical Excellence clinical guidelines relating to the use of rapid tranquilisation (NG 10, 2015).

Rapid tranquilisation is considered a form of restraint. As such this policy should be used in conjunction with the relevant Trust policies on restraint and Mental Capacity Act.

 

Policy Details

Download: N/A
Compiled by: Sumbal Chaudhry, Carolyn Adamson, SABP
Ratified by: Drugs and Therapeutics Committee
Date Ratified: September 2017
Date Issued: December 2017
Review Date: September 2019
Target Audience: All staff
Contact name: Sumbal Chaudhry, Carolyn Adamson, SABP

 

See also:

  • Dementia Delirium Care Pathway
  • Mental Health Act information
  • Mental Capacity Policy
  • Care of Patients Requiring Close Observation Policy