Transfer should be to an appropriate hospital:
if an organic cause is suspected, to a general hos-pital; if a psychiatric cause is suspected, to a hospital
with psychiatrist attention 24 hours a day.
The mode of transfer depends on patient state. If
the patient is co-operative, standard ambulance
service or family vehicles may be used, but always
accompanied. If the patient is mechanically restrained,
a psychiatric transport unit is required; by
defect, a basic life support (BLS) unit is required.
If the patient has been sedated, a BLS ambulance
is necessary, with monitoring to avoid the risk of
broncoaspiration.
It is most important that the physician make a
written record of all the details of the situation
(including lesions produced and material damage
done), the therapeutic measures adopted and the
outcomes), primarily for possible legal repercussions
but also for further preventive, therapeutic
or staff training purposes31.