Behavioural emergency — organic first and the MSE

Organic first: vitals including temperature, glucose, time course, focal neurology — confirm the screening-element list against local psychiatry-ED protocol; the held scoping review maps medical-screening practices (history-taking, vitals, examination, imaging, ECG) and notes society recommendations against routine blanket labs.^[1]

MSE domains and sedation (examiners expect structure): appearance/behaviour, speech, mood/affect, thought form and content (include suicidal/homicidal ideation), perception, cognition, insight/judgement — de-escalate first; IM sedation per local agitation protocol with airway and monitoring ready. Held methamphetamine-agitation data: droperidol median 5 mg TAS 16 min, olanzapine median 10 mg TAS 16 min, midazolam median 5 mg TAS 13 min, lorazepam median 2 mg TAS 29 min; no difference in adverse events.^[2] Confirm agent choice against local protocol; avoid IM olanzapine + IM benzo per local guidance.

^[3]Legal: capacity assessment; if serious risk and statutory criteria met, complete Mental Health Act detention; document risks, least restrictive option, and medical treatments given under necessity where applicable — confirm detention specifics against local mental-health legislation.