Algorithm for Acute ED Management of Excited Delirium 



Pearls for Appropriate Restraint:

- 1 person for each limb 

- 1 person to lead the restraint and manage airway 

- Restraints should be secure enough to restrain the patient, but easily removable if the patient begins to vomit, seize, or develop airway compromise 

- Use a non-rebreather with oxygen as a spit mask to ensure 100% oxygen 

- Apply restraints in the level restrictive manner and for the shortest period of time 

- Apply padding between patient and restraints to prevent neuromuscular injury 

- Avoid pressure on face, neck, or chest. 



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