Summary
- Agitation and aggression in children and adolescents in the health care setting can be dangerous and distressing for patients, families and staff. Agitation and aggression can disrupt care, cause injury, or necessitate use of physical restraint.
Agitation is a symptom, like pain, with many potential etiologies and often multiple factors contributing in the moment.
Differential Diagnoses
- Pain
- Delirium
- Intoxication
- Anxiety
- Developmental and cognitive disabilities
- Behavioural disorders
- Trauma
- Mania
- Psychosis
- Sensory or physical limitations
- Difficulty communicating needs
Management
- Non-pharmacologic approaches used for de-escalation should be employed early with a preventative, proactive approach.
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BCCH PICU Management of Severe Acute Agitation Guideline [Internet]. BCCH PICU; 2023. Available from: https://shop.healthcarebc.ca/phsa/BCWH_2/Pharmacy,%20Therapeutics%20and%20Nutrition/C-05-07-62916.pdf
Child Health BC. Provincial Least Restraint Guideline. January 2022. Available from: https://childhealthbc.ca/mhsu/least_restraint/guideline