ArticlePediatrics2023
Standardizing and Improving Care for Pediatric Agitation Management in the Emergency Department.
Article in Pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 31 citations in OpenAlex.
- A Research Agenda for Acute Pediatric Mental and Behavioral Health Emergencies.Annals of emergency medicine · 2026Article
- Context Matters: Variation in Pharmacologic Management of Pediatric Agitation Across Emergency and Inpatient Psychiatric Settings.Journal of child and adolescent psychopharmacology · 2026Article
- Predictive factors for psychotropic medication prescription in child and adolescent psychiatric emergency care: a machine learning approach using a health data warehouse.European child & adolescent psychiatry · 2026Article
- Implementation of a Standardized Management Algorithm for Cannabis Hyperemesis Syndrome in a Pediatric Emergency Department.Pediatric emergency care · 2026Article
- The impact of structured training on the management of agitated pediatric patients in the emergency department: changes in knowledge and self-efficacy perceptions of physicians.BMC pediatrics · 2026Article
- Pediatric Emergency Agitation Care Enhancement: Protocol for a Prospective Mixed Methods Study.JMIR research protocols · 2026Article
- In Pursuit of Calm: Strategies to Manage Pediatric Acute Agitation.Annals of emergency medicine · 2025Article
- It's Time to Get on Board: Solutions to the Pediatric Behavioral Health Boarding Crisis.Annals of emergency medicine · 2025Article
- Research Agenda in Childhood Impairing Emotional Outbursts: A Report of the AACAP Presidential Taskforce on Emotional Dysregulation.JAACAP open · 2025Article
- Qualitative Exploration of Health Care Professionals' Experiences Caring for Young People With Acute Severe Behavioral Disturbance in the Acute Care Setting.Journal of the American College of Emergency Physicians open · 2025Article
- Review article: Scoping review of interventions that reduce mechanical restraint in the emergency department.Emergency medicine Australasia : EMA · 2025Article
- Effects of standardized nursing protocol on nursing quality and complications in pediatric patients with massive scalp hematoma undergoing negative pressure drainage.American journal of translational research · 2025Article
- Association of emergency department characteristics with presence of recommended pediatric-specific behavioral health policies.Journal of the American College of Emergency Physicians open · 2024Article
- Strategies for optimal management of pediatric acute agitation in emergency settings.Journal of the American College of Emergency Physicians open · 2024Article
- Use of Electronic Health Record-Based Measures to Assess Quality of Care for Pediatric Agitation.Hospital pediatrics · 2024Article
- Reducing Physical Restraint Use in the Medical Behavioral Unit.Pediatrics · 2024Article
- De-escalation of the Agitated Pediatric Patient: A Standardized Patient Case for Pediatric Residents.MedEdPORTAL : the journal of teaching and learning resources · 2024Article
- A Qualitative Assessment of Barriers and Proposed Interventions to Improve Acute Agitation Management for Children With Mental and Behavioral Health Conditions in the Emergency Department.Journal of the Academy of Consultation-Liaison PsychiatryArticle
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesPediatric mental health emergency department (ED) visits are rising in the United States, with more visits involving medication for acute agitation. Timely, standardized implementation of behavioral strategies and medications may reduce the need for physical restraint. Our objective was to standardize agitation management in a pediatric ED and reduce time in physical restraints.
methodsA multidisciplinary team conducted a quality improvement initiative from September 2020 to August 2021, followed by a 6-month maintenance period. A barrier assessment revealed that agitation triggers were inadequately recognized, few activities were offered during long ED visits, staff lacked confidence in verbal deescalation techniques, medication choices were inconsistent, and medications were slow to take effect. Sequential interventions included development of an agitation care pathway and order set, optimization of child life and psychiatry workflows, implementation of personalized deescalation plans, and adding droperidol to the formulary. Measures include standardization of medication choice for severe agitation and time in physical restraints.
resultsDuring the intervention and maintenance periods, there were 129 ED visits with medication given for severe agitation and 10 ED visits with physical restraint use. Among ED visits with medication given for severe agitation, standardized medication choice (olanzapine or droperidol) increased from 8% to 88%. Mean minutes in physical restraints decreased from 173 to 71.
conclusionsImplementing an agitation care pathway standardized and improved care for a vulnerable and high-priority population. Future studies are needed to translate interventions to community ED settings and to evaluate optimal management strategies for pediatric acute agitation.
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