Pediatric Catatonia

Catatonia is a syndrome that consists of motor and behavioral signs and symptoms in the setting of neurochemical insult. It can be seen with psychiatric, neuromedical, and substance induced conditions. Though the prevalence of catatonia among the general pediatric population has not been established, it is estimated to be between 0.6% and 17% among child and adolescent psychiatric inpatients [1]. Pediatric patients with catatonia are mostly likely to have a primary diagnosis of psychotic disorder (18.3%) or a neurologic, developmental, and inflammatory illness, such as autoimmune and infectious processes (11.8%) [2]. In comparison, adult patients have a higher proportion of underlying mood disorders, especially bipolar disorder [4].

The Acutely Agitated Child in the Emergency Department

A 9-year-old boy with a history of oppositional defiant disorder, as well as prior admissions to a psychiatric hospital for behavioral concerns, presents to the Emergency Department (ED) of an academic children’s hospital with acute agitation. The patient is brought to the ED via ambulance by emergency medical services and police...

Pediatrics, Social EM, PsychiatryTaylor MarquisSeptember 10, 2024pediatric EM, agitation, safety, PsychiatryComment

Angioedema?

A female in her 30’s presents to the emergency department for acute onset of facial swelling, shortness of breath and a change to the sound of her voice. Although she denied any known allergic exposures, she self-administered an epi-pen at home with little improvement in her symptoms…

Emergency Medicine, ENT, PsychiatryKaitlin LipnerJanuary 30, 2023Emergency Medicine, Airway, PsychiatryComment

TIPS for Managing the Acutely Agitated Patient

Emergency medicine practitioners commonly care for acutely violent or agitated patients, some of whom may be psychotic, intoxicated, or affected by another pathology. Consequently, medical personnel are more likely to experience work-place violence than police officers or prison guards, with a full 100% of ED staff experiencing verbal violence, and 35-80% reporting a history of physical violence while at work. While it is critical to initiate a work-up to diagnose the underlying cause of a patient’s behavioral dysregulation, it is of primary importance to control the patient’s behavior both for their safety and the safety of the patient’s caregivers…

Community EM, PsychiatryErica LashFebruary 18, 2020Psychiatry, altered mental status, agitation, haldol, ativan, AEIOU TIPS, safetyComment

Catatonia

Community EMAmy Matson April 5, 2019Psychiatry, catatonia, NeurologyComment

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