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Assessing and Managing Agitation During Early Recovery in Children With Moderate-to-Severe Traumatic Brain Injury in
Sarah J Knight1, Taylor Jenkin, Vicki Anderson
1Author Affiliations:Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia (Drs Knight, Jenkin, Anderson, Tavender, Ms Pinto, and Dr Scheinberg); Department of Paediatrics (Drs Knight, Jenkin, Anderson, Tavender, Ms Pinto, and Dr Scheinberg), Melbourne School of Psychological Sciences (Drs Knight and Anderson), Department of Critical Care (Dr Tavender), The University of Melbourne, Parkville VIC, Australia; Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, Australia (Drs Knight, Jenkin, and Scheinberg); Australian Catholic University, Melbourne, Australia (Dr Tavender); School of Psychological Sciences (Dr McKay), Department of Neuroscience (Dr Lannin), Monash University, Clayton, VIC, Australia; and Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, VIC, Australia (Dr McKay).
Insights
Agitation is common after pediatric moderate-to-severe traumatic brain injury (TBI). Clinicians use various interventions but rarely formal measures for assessing agitation in children during TBI recovery.
Area of Science:
- Pediatric neurology
- Neurorehabilitation
- Clinical practice guidelines
Background:
- Agitation is a frequent challenge during early recovery from moderate-to-severe traumatic brain injury (TBI) in children and adolescents.
- Limited research exists to guide best practices for managing agitation in this population.
Purpose of the Study:
- To investigate current clinical practices for assessing and managing agitation in children recovering from moderate-to-severe TBI.
- To identify gaps in current approaches to pediatric TBI agitation management.
Main Methods:
- A 2024 cross-sectional anonymous survey was emailed to Australian clinicians caring for children with moderate-to-severe TBI.
- Survey participants included medical, nursing, and allied health professionals in various pediatric care settings.
Main Results:
- Formal measures for evaluating, monitoring, and documenting agitation are seldom used in pediatric TBI recovery.
- A broad spectrum of pharmacological and non-pharmacological interventions are employed for agitation management.
- 58 clinicians participated, representing diverse pediatric care environments.
Conclusions:
- Developmentally appropriate agitation assessment measures are needed for clinical implementation in pediatric TBI.
- Further research is crucial to establish evidence-based interventions for agitation in pediatric TBI recovery.
Background:
Agitation is a common experience in the early stages of recovery from moderate-to-severe traumatic brain injury (TBI) at any age, but there is limited research evidence to guide best practice for children and adolescents.
Objective:
We aimed to explore current approaches to the assessment and management of agitation following pediatric moderate-to-severe TBI.
Methods:
In 2024, a cross-sectional anonymous survey was distributed via email to clinicians involved in care of children during early moderate-to-severe TBI recovery in Australia.
Results:
Respondents were 58 clinicians (medical, nursing, and allied health) who worked in pediatric emergency, intensive care, acute, or inpatient rehabilitation settings. Findings indicated that formal measures are rarely used to evaluate, monitor, and document agitation in children with moderate-to-severe TBI in the early stages of recovery, despite a wide range of pharmacological and non-pharmacological interventions being used in its management.
Conclusion:
Future research is critical to ensure that developmentally appropriate measures of agitation are implemented in clinical practice following pediatric moderate-to-severe TBI and to address the lack of evidence for the range of interventions used.
