Intranasal Drug Administration for Psychomotor Agitation as a Safe and Effective Prehospital Intervention: An Integrative Review

Abstract

Introduction: Psychomotor agitation represents a complex medical emergency, particularly challenging in prehospital settings. Since March 2020, the incidence of psychomotor agitation has significantly increased. Rationale: Emergency Medical Services (EMS) frequently serve as the first point of contact, bearing the critical responsibility of effectively managing these situations. Objective: This was to assess the feasibility and suitability of the intranasal route for administering pharmacological therapy in the prehospital management of patients experiencing psychomotor agitation. Materials and Methods: An integrative review of the literature was conducted to evaluate the use of the intranasal route for drug administration in patients with psychomotor agitation in prehospital settings. The review was carried out between September 2022 and July 2024. A total of 454 articles were identified, 15 of which met the inclusion criteria. These were supplemented by an additional 10 records, resulting in the analysis of 25 studies. Results: Seventeen studies outlined protocols for managing agitated patients, five described the correct technique for intranasal drug administration, and eleven identified drugs suitable for this route. Conclusions: The intranasal route is a safe, rapid, and accessible method for the pharmacological containment of agitated patients in prehospital settings, particularly for individuals who are uncooperative.

Keywords

• intranasal drug administration
• psychomotor agitation
• out-of-hospital settings
• emergency medical services
• emergency nursing