Neuropsychiatric Stabilization in Youths on the Autism Spectrum in the Pediatric Emergency Department: A Call for Practice Standardization

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care Pub Date : 2025-01-07 DOI:10.1016/j.pedhc.2024.11.011

Lauren Decker DNP, APRN, CPNP, CPMHS, Julee Waldrop DNP, APRN, FNP-BC, PNP-PC, EBP-C FAANP, FAAN, Anne Derouin DNP, APRN, PNP-PC, PMHS, FAANP, ANEF

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引用次数: 0

Abstract

Introduction

Children and adolescents with neurodevelopmental and psychiatric comorbidities, particularly autism spectrum disorder and developmental delays (ASD/DD), present unique challenges in pediatric emergency department (PED) settings. Youths with ASD/DD are prone to sensory overload and frequently exhibit agitation and/or aggression, necessitating specialized interventions. However, PEDs lack standardized protocols for managing behavioral dysregulation in this vulnerable population, often relying on anecdotal treatment approaches that hinder the provision of safe, effective and individualized care.

Methods

A review of the literature and current agitation guidelines was conducted and analyzed inform the development of a clinical pathway tailored to the specific neuropsychiatric needs of youths with ASD/DD in the PED.

Results

A comprehensive clinical pathway was formulated to equip healthcare teams with safe and effective prevention, de-escalation and impact mitigation strategies, including environmental modifications, behavioral interventions, caregiver engagement and evidence-based pharmacologic guidelines.

Discussion

Implementing this standardized framework will enhance patient outcomes, improve safety, and ensure compassionate, patient-centered care in PEDs.

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儿童急诊科自闭症谱系青少年的神经精神稳定：对实践标准化的呼吁

患有神经发育和精神合并症的儿童和青少年，特别是自闭症谱系障碍和发育迟缓（ASD/DD），在儿科急诊科（PED）的设置中提出了独特的挑战。患有ASD/DD的青少年容易感觉超载，经常表现出躁动和/或攻击性，需要专门的干预。然而，儿科医生缺乏管理这一弱势群体行为失调的标准化方案，往往依赖于轶事治疗方法，阻碍了提供安全、有效和个性化的护理。方法回顾文献和当前的躁动指南，并对其进行分析，为PED中患有ASD/DD的青少年的特定神经精神需求量身定制临床途径。结果制定了一套全面的临床路径，为医疗团队提供安全有效的预防、降级和缓解影响的策略，包括环境改变、行为干预、护理人员参与和循证药物指导。实施这一标准化框架将提高患者的治疗效果，提高安全性，并确保儿科医生富有同情心、以患者为中心的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Health Care NURSING-PEDIATRICS

CiteScore

3.40

自引率

10.70%

发文量

140

审稿时长

24 days

期刊介绍： The Journal of Pediatric Health Care, the official journal of the National Association of Pediatric Nurse Practitioners, provides scholarly clinical information and research regarding primary, acute and specialty health care for children of newborn age through young adulthood within a family-centered context. The Journal disseminates multidisciplinary perspectives on evidence-based practice and emerging policy, advocacy and educational issues that are of importance to all healthcare professionals caring for children and their families.