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Updated: Jun 21, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Pharmacotherapy considerations for pediatric acute agitation management in the emergency department

Kimberly P Mills1, Megan Kemper1, Natchanan Charatcharungkiat1

  • 1Department of Pharmacy, St. Louis Children's Hospital, St. Louis, MO, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|July 15, 2024
PubMed

Insights

Managing acute agitation in pediatric patients requires careful consideration. While non-pharmacological methods are preferred, medication may be needed for safety, though evidence for pediatric pharmacotherapy is limited.

Area of Science:

  • Pediatric Emergency Medicine
  • Pharmacology
  • Clinical Practice Guidelines

Background:

  • Acute agitation in pediatric patients is a common challenge in emergency departments (EDs).
  • Management is often multifactorial, requiring prompt intervention.
  • Non-pharmacological de-escalation is the first-line approach.

Purpose of the Study:

  • To review the current literature on pharmacological management of acute agitation in pediatric patients.
  • To discuss practical considerations for empiric medication use in the ED.

Main Methods:

  • Literature review of pharmacological agents for pediatric acute agitation.
  • Analysis of practical considerations for emergency department (ED) use.

Main Results:

  • Limited guidance exists for medication selection and dosing in pediatric acute agitation.
  • Current pharmacotherapy varies based on institutional protocols and provider preference.
  • Evidence suggests institutional protocols may improve patient outcomes.

Conclusions:

  • ED providers are crucial in managing pediatric acute agitation.
  • Pharmacological treatment is necessary when safety is compromised.
  • Further research is needed to optimize pharmacotherapy for pediatric acute agitation in the ED.
Abstract

Keywords:
aggressionbehavioral healthemergency departmentemergency psychiatrymental healthpediatric agitation

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