The mental health crisis in children and adolescents presents a unique challenge for pediatric providers in the inpatient setting. Patients are presenting to the emergency department in acute psychiatric crises, but the increased need for behavioral health services is met with an already limited supply of behavioral health services and facilities. As such, these patients are hospitalized on acute care floors, which can serve to exacerbate symptoms of aggression regardless of cause and complicates treatment and harm prevention strategies. We present a comprehensive management approach to the acutely agitated pediatric patient with aggressive behaviors, including prevention of symptoms in patients with risk factors; nonpharmacological approaches to de-escalation, including the use of restraint; and common oral and parenteral psychopharmacological agents. Such strategies are considered from a medical, ethical, and legal standpoint with the goal of maintaining safety and minimizing harm to patients, families, and staff. [Pediatr Ann. 2024;53(8):e293-e298.].

中文翻译：

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在住院环境中治疗有攻击性行为的儿童和青少年。


儿童和青少年的心理健康危机给住院儿科提供者带来了独特的挑战。患有急性精神危机的患者被送往急诊室，但行为健康服务和设施的供应本已有限，但对行为健康服务日益增长的需求却无法满足。因此，这些患者被送往急症护理楼层住院，无论原因如何，这都可能加剧攻击性症状，并使治疗和伤害预防策略复杂化。我们针对具有攻击性行为的急性躁动儿科患者提出了一种全面的管理方法，包括预防具有危险因素的患者的症状；非药物降级方法，包括使用约束措施；以及常见的口服和肠胃外精神药理学药物。此类策略是从医学、伦理和法律的角度考虑的，目的是维护安全并尽量减少对患者、家庭和工作人员的伤害。 [小儿安。 2024;53(8):e293-e298.]。