EM@3AM: Agitation in the Elderly
A 72-year-old female with a past medical history of Alzheimer’s dementia is transferred from her SNF with hallucinations and agitation. On ED arrival, she is looking around and appears to be responding to internal stimuli. She is not following commands, picking off the EKG leads, pushing the healthcare technician away from her, and anytime someone tries to start an IV or put a blood pressure cuff on her, she swings at them and has already punched EMS and one of the nurses. She is unable to be verbally redirected for IV establishment but allows you to get an EKG and opening set of vitals, which are normal. What’s your next step in evaluation and management?
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