TY - JOUR
T1 - Management of paediatric acute severe behavioural disturbance in emergency departments across Australia
T2 - A PREDICT survey of senior medical staff
AU - Bourke, Elyssia M.
AU - Knott, Jonathan C.
AU - Craig, Simon
AU - Babl, Franz E.
AU - on behalf of the Paediatric Research in Emergency Departments International Collaborative (PREDICT)
N1 - Funding Information:
We thank the PREDICT site representatives who have distributed the surveys: Franz Babl (Royal Children's Hospital), Amie Beattie (Tamworth Rural Referral Hospital), Meredith Borland (Perth Children's Hospital), Elyssia Bourke (Ballarat Health Services), Paul Buntine (Eastern Health: Box Hill Hospital, Angliss Hospital, Maroondah Hospital), Simon Craig (Monash Children's Hospital), Lalith Gamage (Port Augusta Hospital), Shane George (Gold Coast University Hospital), Nicola Ghedina (St John of God Midland Hospital), Jeremy Furyk (Barwon Health), Lambros Halkidis (Cairns Hospital), Jason Hort (Children's Hospital at Westmead), Alex King (Toowoomba Hospital), Amit Kochar (Women's and Children's Hospital Adelaide), Anna Lithgow (Royal Darwin Hospital), Ben McKenzie (Bendigo Health), Rob Millar (Austin Health), Natalie Phillips (Queensland Children's Hospital), Arjun Rao (Sydney Children's Hospital), Stephen Teo (Blacktown and Mt. Druitt Hospitals), Viet Tran (Royal Hobart Hospital), Tristan Turner (Townsville Hospital and Health Service), Russell Young (Albany Health Service), Michael Zhang (John Hunter Hospital). EMB is funded by a National Health and Medical Research Council (NHMRC) postgraduate scholarship, Canberra, Australia. FEB is funded by a grant from the Royal Children's Hospital Foundation and a NHMRC Practitioner Fellowship. The Royal Children's Hospital and the Murdoch Children's Research Institute, Parkville, Australia, are supported by the Victorian Government's Operational Infrastructure Support Program. This project is supported by the Medical Research Future Fund (MRFF) Million Minds Mission 2019 (GNT1179137): The Kids are Not Okay: ED management of acute mental health crises in children and young people. Open access publishing facilitated by The University of Melbourne, as part of the Wiley ‐ The University of Melbourne agreement via the Council of Australian University Librarians.
Publisher Copyright:
© 2022 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.
PY - 2023/4
Y1 - 2023/4
N2 - Objective: Acute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in EDs. It poses a significant risk to the patient and those around them. Little is known about the epidemiology or most effective management in the paediatric population. The aim of the present study is to clarify the practice of senior emergency doctors in Australia when managing paediatric ASBD. Methods: The present study was a voluntary electronic questionnaire distributed to and undertaken by senior medical staff in EDs affiliated with the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network. Respondents reported on exposure to and confidence in managing paediatric ASBD and their current practices. Results: A total of 227 (33%) clinicians completed the survey between February and May 2020. Most clinicians were caring for at least two young people with ASBD each week (72%), felt confident regarding the majority of components of management and referred to local clinical practice guidelines (69%). Agitation/sedation rating scales were seldom used (19%). There was a significant variation in self-reported management practices. The choice of whether to use medication at all, the medication chosen and route of administration all varied greatly. Respondents were more willing to provide parenteral medication to young people reported as having recreational drug intoxication (84%) than those with neurodevelopment disorders (65%) when the same degree of agitation was reported. Conclusions: Within Australia, there is considerable variation in paediatric ASBD practice, in particular regarding medication provision. Further prospective research is required to inform best clinical practice.
AB - Objective: Acute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in EDs. It poses a significant risk to the patient and those around them. Little is known about the epidemiology or most effective management in the paediatric population. The aim of the present study is to clarify the practice of senior emergency doctors in Australia when managing paediatric ASBD. Methods: The present study was a voluntary electronic questionnaire distributed to and undertaken by senior medical staff in EDs affiliated with the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network. Respondents reported on exposure to and confidence in managing paediatric ASBD and their current practices. Results: A total of 227 (33%) clinicians completed the survey between February and May 2020. Most clinicians were caring for at least two young people with ASBD each week (72%), felt confident regarding the majority of components of management and referred to local clinical practice guidelines (69%). Agitation/sedation rating scales were seldom used (19%). There was a significant variation in self-reported management practices. The choice of whether to use medication at all, the medication chosen and route of administration all varied greatly. Respondents were more willing to provide parenteral medication to young people reported as having recreational drug intoxication (84%) than those with neurodevelopment disorders (65%) when the same degree of agitation was reported. Conclusions: Within Australia, there is considerable variation in paediatric ASBD practice, in particular regarding medication provision. Further prospective research is required to inform best clinical practice.
KW - child psychiatry
KW - hypnotic and sedative
KW - paediatric emergency medicine
KW - psychomotor agitation
UR - http://www.scopus.com/inward/record.url?scp=85141387803&partnerID=8YFLogxK
U2 - 10.1111/1742-6723.14105
DO - 10.1111/1742-6723.14105
M3 - Article
C2 - 36328402
AN - SCOPUS:85141387803
SN - 1742-6731
VL - 35
SP - 254
EP - 260
JO - EMA - Emergency Medicine Australasia
JF - EMA - Emergency Medicine Australasia
IS - 2
ER -