ReviewJournal of the American College of Emergency Physicians open2020
Improving the management of acutely agitated patients in the emergency department through implementation of Project BETA (Best Practices in the Evaluation and Treatment of Agitation).
Review in Journal of the American College of Emergency Physicians open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 47 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder.Journal of addiction medicineGuideline
- Trauma-informed procedural training in emergency medicine: a multi-site randomized control pilot study.BMC emergency medicine · 2026Trial
- Trial
- A Realist Evaluation of a Rapid Response System for Mental State Deterioration in Acute Hospital Settings.Journal of advanced nursing · 2026Article
- Implementation of a Novel Agitated Behavior Score and Its Association with Code Violet Activation: A Case Series.Clinical practice and cases in emergency medicine · 2026Article
- National survey of Dutch emergency physicians on pharmacological sedation practices for extreme agitation.Toxicology reports · 2026Article
- A Comparative Analysis of Psychiatric Consultations Across Emergency, Hospital, and Community Mental Health Settings.Journal of clinical medicine · 2026Article
- Pediatric Emergency Agitation Care Enhancement: Protocol for a Prospective Mixed Methods Study.JMIR research protocols · 2026Article
- Evolution Over Time of EMS Statewide Treatment Protocols on Prehospital Agitation in the United States.Prehospital emergency care · 2026Article
- Adapting to the digital age in psychiatry: evaluating change in emergency department nurses and psychiatrists' views toward telepsychiatry for involuntary hospitalization.Frontiers in digital health · 2026Article
- The Diagnosis and Treatment of Stimulant-Related Emergencies.Deutsches Arzteblatt international · 2025Review
- Oral Medications for Treating Agitation in a Safety Net Emergency Department.JAMA network open · 2025Article
- Article
- Virtual Reality for Workplace Violence Training of Health Care Workers: Pilot Mixed Methods Usability Study.JMIR serious games · 2025Article
- Association between patient primary language, physical restraints, and intramuscular sedation in the emergency department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Article
- Predicting Agitation Events in the Emergency Department Through Artificial Intelligence.JAMA network open · 2025Article
- Reducing physical assaults on residents through implementation of project BETA: Best practices in the evaluation and treatment of agitation.AEM education and training · 2025Article
- A Comprehensive Understanding of Psychomotor Agitation: From Causes to Hospital Care.Current neuropharmacology · 2025Review
- De-escalating aggression in acute inpatient mental health settings: a behaviour change theory-informed, secondary qualitative analysis of staff and patient perspectives.BMC psychiatry · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
Abstract
Agitated patients presenting to the emergency department (ED) can escalate to aggressive and violent behaviors with the potential for injury to themselves, ED staff, and others. Agitation is a nonspecific symptom that may be caused by or result in a life-threatening condition. Project BETA (Best Practices in the Evaluation and Treatment of Agitation) is a compilation of the best evidence and consensus recommendations developed by emergency medicine and psychiatry experts in behavioral emergencies to improve our approach to the acutely agitated patient. These recommendations focus on verbal de-escalation as a first-line treatment for agitation; pharmacotherapy that treats the most likely etiology of the agitation; appropriate psychiatric evaluation and treatment of associated medical conditions; and minimization of physical restraint/seclusion. Implementation of Project BETA in the ED can improve our ability to manage a patient's agitation and reduce the number of physical assaults on ED staff. This article summarizes the BETA guidelines and recent supporting literature for managing the acutely agitated patient in the ED followed by a discussion of how a large county hospital integrated these recommendations into daily practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.