The situation should be viewed as a medical emergency.
Anyone approaching the patient should be protected from the patient.
Steps to take during the initial management of a patient with excited delirium:
(1) If possible try to calm the patient with verbal resassurances.
(2) If physical restraint is needed, try to control the patient as quickly as possible, avoiding a prolonged struggle.
(3) Administer sedation as soon as possible. This may involve a benzodiazepine and an antipsychotic drug.
(4) Try to calm and reassure the patient.
(5) Avoid unnecessary stimuli (loud noises such as sirens, bright lights).
(6) Keep the patient under direct observation at all times.
(7) Make sure that the patient’s airway is protected.
(8) Take the patient to the hospital as soon as possible. Do not take the patient to a jail for booking.
(9) If possible measure the patient’s body temperature. It may be necessary to cool the patient if marked hyperthermia is present.
(10) Evaluate the patient for dehydration. Intravenous hydration may be necessary but must be done cautiously.
