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SAFEST Psychiatry
SAFEST Psychiatry
staff. In these cases, it is important to recognize the early warning signs of impending violence and
adopt an approach to management that reduces the likelihood of injury to staff and patient. Early
warning signs of impending violence include threatening statements, clenched fists, loud
vocalizations, shifting body positions toward a fighting posture, agitated movements, and striking
inanimate objects. If such behavior is detected, adopt the S.A.F.E.S.T. approach:
SpacingMaintain distance from the patient. Allow both the patient and you to have equal
access to the door. Do not touch a violent person.
FocusWatch the patient's hands. Watch for potential weapons. Watch for escalating
agitation.
StabilizationIf necessary, use three stabilization techniques to get control of the situation:
physical restraint, sedation, and chemical restraint.
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TreatmentOnce the patient is more manageable, initiate treatment based on the patient's
symptoms. The patient may refuse treatment and may need to receive treatment involuntarily
in order to ensure his or her safety.