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The STAMP Hack—Staring, Tone and volume of voice, Anxiety, Mumbling, and Pacing

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STAMP (Staring, Tone and volume of voice, Anxiety, Mumbling, and Pacing) is a set of assessment criteria created for emergency room nurses at the City College London based on their observations of violent patient behavior. Utilization of this tool is as simple as learning the acronym and observing the behavior of agitated participants. Clients exhibiting some or all of these factors are much more likely to become highly agitated and should be approached for de-escalation:

  • S – Staring: Prolonged or intense staring can indicate heightened aggression or agitation. It can make others feel uncomfortable or threatened.
  • T – Tone and Volume of Voice: Changes in tone or volume, such as speaking loudly, harshly, through clenched teeth, or with a threatening tone, can be a sign of agitation.
  • A – Anxiety: Visible signs of anxiety, such as fidgeting, restlessness, or a tense posture, can indicate that a person is becoming agitated or distressed.
  • M – Mumbling: Incoherent or under-the-breath speech can be a sign of frustration or agitation. It may indicate that the person is internalizing anger or struggling to communicate effectively.
  • P – Pacing: Restless movements, such as pacing back and forth, can be a sign of agitation or an inability to remain calm.

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