Humane Rapid Tranquilization of an Agitated Patient with an Implantable Cardioverter Defibrillator

A 76-year-old man with dementia and a history of cardiac issues, including an implantable cardioverter defibrillator (ICD), was admitted to a psychiatric ward due to agitation and personality changes. During his stay, an incident occurred where his ICD activated multiple times after a security guard attempted to retrieve crumpled clinical notes from his pocket. To manage his agitation without exacerbating his cardiac condition, staff employed verbal de-escalation and one-to-one nursing instead of pharmacological interventions. Over a 5-week admission, his cognitive function improved, and he was discharged with ongoing support. A year later, he reported feeling well, with only minor memory issues, and his ICD showed no abnormalities.