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. 2019 Mar;20(2):409-418.
doi: 10.5811/westjem.2019.1.41344. Epub 2019 Feb 19.

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry

Ruth Gerson  1 , Nasuh Malas  2 , Vera Feuer  3 , Gabrielle H Silver  4 , Raghuram Prasad  5 , Megan M Mroczkowski  6
Affiliations

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry

Ruth Gerson et al. West J Emerg Med. 2019 Mar.

Erratum in

Abstract

Introduction: Agitation in children and adolescents in the emergency department (ED) can be dangerous and distressing for patients, family and staff. We present consensus guidelines for management of agitation among pediatric patients in the ED, including non-pharmacologic methods and the use of immediate and as-needed medications.

Methods: Using the Delphi method of consensus, a workgroup comprised of 17 experts in emergency child and adolescent psychiatry and psychopharmacology from the the American Association for Emergency Psychiatry and the American Academy of Child and Adolescent Psychiatry Emergency Child Psychiatry Committee sought to create consensus guidelines for the management of acute agitation in children and adolescents in the ED.

Results: Consensus found that there should be a multimodal approach to managing agitation in the ED, and that etiology of agitation should drive choice of treatment. We describe general and specific recommendations for medication use.

Conclusion: These guidelines describing child and adolescent psychiatry expert consensus for the management of agitation in the ED may be of use to pediatricians and emergency physicians who are without immediate access to psychiatry consultation.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Figures

Figure
Figure
Clinical decision flow chart. PO, by mouth; IM, intramuscular; IV, intravenous; NGT, nasogastric tube; EtOH, ethanol; Utox, urine toxicology; PCP, phencyclidine; EPS, extrapyramidal symptoms; ASD, autism spectrum disorder; DD, developmental disability; BZD, benzodiazepines; ODT, orally dissolving tablet; PTSD, post-traumatic stress disorder; ADHD, attention deficit hyperactivity disorder; ODD, oppositional defiant disorder; CD, conduct disorder; pt, patient. *For these etiologies, in absence of consensus, medication options are listed alphabetically; formula image Do not give olanzapine and benzodiazepines within one hour of each other.
See this image and copyright information in PMC

References

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