Lunch and Learn: Acute behavioural disturbances

Severe agitation or aggression that doesn't de-escalate with verbal intervention and places the patient or others at risk can be categorised as acute behavioural disturbance (ABD). This is a common and time-critical presentation in prehospital, emergency and acute care. ABD is a clinical presentation rather than a diagnosis, and the underlying cause may be medical, substance-related, psychological, or a combination of factors.

Course overview 

This 30 minute case-based webinar provides a structured, person-centred approach to the acutely agitated patient. Timed to World Mental Health Day, it also considers the language and stigma that shape care, and reflects current Australian and New Zealand guidance on graded de-escalation, safe sedation and the minimisation of restraint. 

What you will learn 

• How to recognise ABD and work through its differential, including reversible medical causes and substance intoxication and withdrawal
• A graded, trauma-informed and culturally safe approach to de-escalation
• Principles of safe pharmacological sedation and post-sedation monitoring, including agent choice and use of the Sedation Assessment Tool
• Why the term ‘excited delirium’ has been withdrawn, and what contemporary, non-stigmatising practice looks like 

Why you should attend 

The session is case-based and applicable at the bedside and in the prehospital environment. It supports safer care for patients and staff and is relevant to nurses and paramedics across emergency, acute, critical care and retrieval settings, as well as to medical practitioners who encounter acute agitation. 

Learning objectives 

1. Identify acute behavioural disturbance and differentiate its common underlying causes including organic/medical, substance-related (intoxication and withdrawal), and primary mental health presentations.
2. Apply a graded, trauma-informed and culturally safe approach to the acutely agitated patient, prioritising environmental measures and verbal de-escalation.
3. Describe recommended treatment approaches to episodes of ABD based on the identified cause.
4. Describe the principles of safe pharmacological sedation and post-sedation monitoring for acute behavioural disturbance, consistent with current Australian and New Zealand guidance.