In this section
Acute Behavioural Disturbance: Code Grey
The most important initial action is to control the behaviour to reduce distress, and to reduce the risk of harm.
Once the behaviour is controlled, further assessment and specific management of the underlying cause should occur.
Focus on "What has worked in the past?" and "Why has this episode occurred?"
No investigations are required emergently.
If pharmacological treatment is required, a step-wise approach should be taken, depending upon the level of agitation. See Acute behavioural disturbance: acute management.
Staff / Self
Have a low threshold for involving local mental health clinicians in the ongoing care of behaviourally disturbed children, to assist in determining whether acute psychiatric admission would be beneficial, and to ensure appropriate community follow-up.
Some children may require medical admission for stabilisation of a medical cause for their behavioural disturbance, or for observation until resolution of drug toxicity and should be referred to the local paediatric team if this is thought to be likely.
Once the behavioural disturbance is controlled, some children will require transfer to a tertiary psychiatric centre. This can be facilitated following an assessment by local mental health clinicians.
Complications from chemical sedation -respiratory depression, hypotension, extrapyramidal reactions.
Child requiring care beyond the comfort level of the hospital.
For emergency advice and paediatric or neonatal ICU transfers, call
the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137
Before discharge, all children with acute behavioural disturbance should have:
Last updated July, 2017