Beyond Project BETA: Advancing Agitation Management Throughout the Lifespan For C-L Psychiatrists

Agitation is a common reason for psychiatric consultation in emergency and inpatient settings. Patients ‎presenting with agitation experience barriers to receive timely diagnosis and treatment. Due to the ‎COVID-19 pandemic and healthcare worker shortages, hospitals are struggling with limited bed ‎availability, prolonged emergency room boarding, and increased frustration and agitation of patients. ‎Without appropriate interventions to address agitation, situations can escalate to violence towards ‎healthcare workers and patient injury and death as potential sequelae. As such, skillfully approaching ‎consults for the agitated patient in a culturally informed and developmentally and diagnostically ‎appropriate manner is important for improving patient outcomes and reducing the risk of workplace ‎violence. ‎

Using small group and case-based discussion, this skills course, sponsored by the Emergency Psychiatry ‎Special Interest Group, will cover the evaluation and management of agitation as it applies to the CL ‎psychiatrist. Specifically, the session will reinforce and expand upon the principles from Project BETA ‎‎(Best Practices for the Evaluation and Treatment of Agitation) by discussing management of child and ‎adolescent patients, geriatric patients and individuals with major neurocognitive disorder, pregnant ‎patients, and individuals with autism and developmental disorders. Diagnostic, nonpharmacologic, and ‎pharmacologic approaches will be reviewed. The speakers will also discuss approaches for treatment-‎refractory agitation as well as managing agitation in critically ill patients. The presenters will discuss ‎disparities in the management of agitation and the role of countertransference and bias in the ‎perception of agitation, including how to provide support and address these issues with the primary ‎team. Participants will have the opportunity to practice hands-on skills for managing agitated patients.‎

‎Agenda Overview‎

‎0-30: Introductions, move to small groups, and brief review of didactic material (via interactive polling) ‎by Dr. Priyanka Amin
‎30-60: Small group discussion and report back on addressing bias in differing approaches to agitation by ‎Drs. Priyanka Amin & Meghan Schott
‎60-90: Case-based discussion for child & adolescent population and individuals with ASD/IDD by Dr. ‎Meghan Schott
‎90-120: Case-based discussion on geriatric agitation including individuals with major neurocognitive ‎disorders and delirium by Dr. Maher Almatrafi
‎120-150: Case-based discussion on agitation management during pregnancy by Dr. Andrew Coulter
‎150-180: Case-based discussion on agitation in critically ill patients by Dr. Bethany Franklin
‎180-210: Case-based discussion on treatment-refractory agitation by Drs. Bethany Franklin & Priyanka ‎Amin
‎210-240: Hands-on skill practice for acute agitation by Dr. Meghan Schott