Severe Agitation
Severe agitation is intense motor or emotional disturbance that creates distress, prevents assessment or risks harm. It is a presentation requiring rapid cause and safety assessment, not a diagnosis.
Key takeaways
- Delirium, low oxygen, infection, low blood sugar, head injury, intoxication or withdrawal can cause agitation and may be life-threatening.
- Sudden onset, altered attention, vital signs, substances, medicines and neurological findings guide the immediate response.
- Verbal de-escalation and a low-stimulation setting are preferred when safe; sedating medicine is selected only for a defined need with monitoring.
Catalogue matches are not an emergency plan and do not indicate that an antipsychotic or sedative is safe.
What should be checked first?
Responders protect the person and others while checking breathing, circulation, glucose, temperature, injury and altered consciousness. A calm approach and space can reduce escalation; untrained physical restraint can cause harm.
When is medicine considered?
Medicine may be needed when severe distress or danger persists despite de-escalation. Haloperidol has selected acute-care roles but can affect movement and heart rhythm. Cause, age, intoxication, pregnancy and monitoring capability alter the choice. See mental health.
When to seek urgent care
Call emergency services for severe agitation with immediate danger, confusion, fever, seizure, head injury, chest pain, breathing difficulty, suspected overdose or withdrawal, or inability to maintain safety.