Department of Child and Adolescent Psychiatry, New York University Langone, 462 1st Avenue, New York, NY 10016, USA.
Department of Psychiatry, Division of Child and Adolescent Psychiatry, C.S. Mott Children's Hospital, University of Michigan Hospital System, 1500 East Medical Center Drive, L5023, SPC 5277, Ann Arbor, MI 48109-5277, USA; Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan Hospital System, 1500 East Medical Center Drive, L5023, SPC 5277, Ann Arbor, MI 48109-5277, USA.
Child Adolesc Psychiatr Clin N Am. 2018 Jul;27(3):367-386. doi: 10.1016/j.chc.2018.02.002.
Acute agitation in children and adolescents in the emergency department carries significant risks to patients and staff and requires skillful management, using both nonpharmacologic and pharmacologic strategies. Effective management of agitation requires understanding and addressing the multifactorial cause of the agitation. Careful observation and multidisciplinary collaboration is important. Medical work-up of agitated patients is also critical. Nonpharmacologic deescalation strategies should be first line for preventing and managing agitation and should continue during and after medication administration. Choice of medication should focus on addressing the cause of the agitation and any underlying psychiatric syndromes.
急诊科儿童和青少年的急性激越对患者和医护人员都存在重大风险，需要熟练的管理技能，采用非药物和药物策略。有效管理激越需要理解和解决激越的多因素原因。仔细观察和多学科协作非常重要。对激越患者进行医学检查也至关重要。非药物降级策略应作为预防和管理激越的一线治疗方法，并应在药物治疗期间和之后持续进行。药物选择应侧重于解决激越的原因和任何潜在的精神科综合征。
