{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:15:50Z","timestamp":1792430150685,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T00:00:00Z","timestamp":1628553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Studies reporting factors associated with paediatric\/adolescent acute behavioural disturbance (ABD) in the Emergency Department (ED) are lacking. The aim of this study is to describe paediatric\/adolescent ED presentations involving ABD events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review of presentations involving ABD events, identified via hospital security log, to a tertiary referral paediatric ED during the 2017 calendar year. Data reported included: cause of presentation, use of sedation\/physical restraint, ED\/inpatient length of stay (LOS) and time requiring security staff presence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 280 reported ABD episodes 26 were excluded leaving 254 events involving 150 patients across 233 presentations of whom 38 (25.3%) presented on multiple occasions. Median age was 14\u2009years (interquartile range (IQR): 13\u201316), 132\/233 (56.7%) were female, 167\/233 (71.7%) primary mental health complaints, 30\/233 (12.9%) deliberate self\u2010harm, 18\/233 (7.7%) deliberate self\u2010poisoning, 11\/233 (4.7%) acute intoxication and 7\/233 (3.0%) other.<\/jats:p><jats:p>Transport to hospital involved police and ambulance in 124\/233 (53.2%), ambulance only 71\/233 (30.5%), police only 16\/233 (6.9%), relative or carer 20\/233 (8.6%), with self\u2010presentation in 2\/233 (0.9%).<\/jats:p><jats:p>Sedation or physical restraint was used in 81\/233 (34.8%), both 38\/233 (16.3%), restraint only 26\/233 (11.2%) and sedation only 17\/234 (7.3%). Intra\u2010muscular droperidol accounted for 57\/96 (59.4%) sedations, IM\/IV benzodiazepines 15\/96 (15.6%), IM\/IV ketamine 5\/96 (5.2%) and 19\/96 (19.8%) other.<\/jats:p><jats:p>Discharge from ED occurred in 171\/233 (73.1%) with median ED LOS 5.1\u00a0h (IQR: 3.5\u20137.7) and median hospital LOS 92.4\u00a0h (IQR: 47.5\u2013273.4) for those admitted. The Mental Health Act was utilised in 183\/233 (78.5%) presentations.<\/jats:p><jats:p>Median security staff time requirement per presentation was 2.4\u00a0h (IQR: 1.0\u20133.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Paediatric\/adolescent ED presentations involving ABD are primarily due to mental health complaints. Less than half require the use of sedation\/physical restraint. Time requiring security staff involvement is a significant resource consumption.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.15668","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T19:19:04Z","timestamp":1628623144000},"page":"110-115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Factors associated with paediatric and adolescent Emergency Department presentations involving acute behavioural disturbance events"],"prefix":"10.1111","volume":"58","author":[{"given":"Caitlyn J","family":"Lovett","sequence":"first","affiliation":[{"name":"Emergency Department John Hunter Hospital  New Lambton Heights New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u2010Anne","family":"Hiles","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of Newcastle  Callaghan New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Calver","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of Newcastle  Callaghan New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy D","family":"Pallas","sequence":"additional","affiliation":[{"name":"Emergency Department John Hunter Hospital  New Lambton Heights New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Thomson Bowe","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics and Adolescent Medicine John Hunter Children's Hospital  New Lambton Heights New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3608-144X","authenticated-orcid":false,"given":"Michael A","family":"Downes","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  Callaghan New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2009.01182.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.03.016"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13496"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2018.02.002"},{"key":"e_1_2_7_6_1","unstructured":"NSW Ministry of Health.Management of patients with acute severe behavioural disturbance in emergency departments.2015Available from:https:\/\/www1.health.nsw.gov.au\/PDS\/pages\/doc.aspx?dn=GL2015_007"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13515"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja18.00213"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.01063"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026001"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.00589"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.00434"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-227X-10-14"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2005.00756.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13485"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13412"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/10903127.2018.1542473"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.11.028"},{"key":"e_1_2_7_19_1","unstructured":"NSW Ministry of Health.Mental Health and Drug and Alcohol Office Mental Health for Emergency Departments \u2013 A Reference Guide.2015. 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