The Agitated Patient in the Emergency Department

A 32-year-old male with a past history of paranoid schizophrenia and methamphetamine use presents to the emergency department requesting help. He is vague in his requests for help and seems paranoid about staff harming him. He is not taking his psychiatric medication. He is directable in triage, but after being placed into a room begins to escalate. By the time the physician and nurse go to see him, he attempts to strike the physician. He is talking loudly and breaks a portable computer. Security must be called immediately to the bedside.