A 28 year old male screams 'the zombies are after me!' He swings his arms wildly and is fearful to stand still. He is unable to acknowledge your presence. What should you do?

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When a patient is violently agitated and not able to engage, safety and rapid control of behavior are the priorities so you can assess and transport safely. De-escalation and nonpharmacologic measures should be tried, but if he remains highly agitated and cannot participate in evaluation, chemically restraining him under medical direction is indicated to quickly calm him and allow assessment for underlying causes (drug intoxication, delirium, head injury, hypoxia, or psychiatric illness). A sedative is the best choice here because it directly reduces agitation and helps you establish a secure environment and proceed with care, whereas relying on physical restraints alone or a taser carries greater risk and may not address the root problem promptly. Calling law enforcement can help with safety, but it does not treat the agitation itself. Ensure continuous monitoring of airway, breathing, and circulation, have equipment ready for airway management, and obtain medical direction for dosing.