Initial assessment and management of agitation and aggression in the paediatric setting

Assessing and managing acute behavioural disturbance in the acute setting is challenging for paediatricians at all stages of their careers. In this article we use a case example of an acutely agitated teenager in a sequence in which they might present to a colleague on the ground. We follow them through considerations of differential diagnosis, investigation, acute management of the disturbance as well as through legal and ethical considerations. We provide details of investigations as well as acute management and point to further resources that the clinician might use. As a mix of psychiatrists and paediatricians we consider a broad differential and bring our understanding of these cases together with the goal of giving a colleague the information they need.