You walk into the examining room to interview a patient. He refused giving vital signs at the triage station until he saw a doctor because he was afraid that the nurse would inject poison into him. He appears agitated and starts raising his voice as soon as you are in the room. You ask him in a calm voice if you could help him and he replies by shouting obscenities and throwing a box of gloves at you. You start to walk toward him, but he says he will kill you if you get any closer. Which of the following is the most appropriate next step in management?
a. Tell the patient he is being uncooperative and is to leave the ED immediately.
b. Have the nurse go into the room alone to try to calm the patient.
c. Let the patient sit in the room for another hour and see if he calms down.
d. Ask the nurse to prepare an injection of lorazepam that you will give to sedate the patient.
e. Alert hospital security that there is a violent patient and prepare to place the patient in physical restraints.
