Pediatric emergency medicine trisk 4209 4209

TABLE 126.29 GUIDELINES FOR MANAGEMENT OF ACUTE ADOLESCENT PSYCHOSIS Diagnose underlying cause Request immediate psychiatric consultation Utilize medical hospitalization, if psychosis due to an underlying medical condition is suspected Request psychiatric consultation with psychotic drug intoxications, either immediately or when mental status stabilizes Use quiet room, family and friends, and constant medical supervision Use emergency agitation medications and restraints as necessary Recognize clinical variations of extrapyramidal reactions to antipsychotic medications POSTTRAUMATIC STRESS DISORDERS PTSD can occur in childhood and adolescence and is usually due to severe trauma during earlier years Children may be more sensitive to the effects of trauma than are adults and thus may have higher rates of PTSD Either the reemergence of the old trauma, the emergence of a new similar one, or the recollection of the original trauma can activate a PTSD Traumatic events involve situations where there was threatened or actual death, serious injury, or disease to someone Highly stressful experiences leading to PTSD in children may include but are not limited to any of the following: physical violence, verbal threats, sexual abuse, long-standing hunger and poverty, as well as medical interventions such as bone marrow transplant, and injury such as burns and motor vehicle accidents Children may respond to traumatic events with intense fear, helplessness or horror, or even disorganized or agitated behavior In addition, the traumatic event is persistently reexperienced in one or more ways, for example, persistent avoidance of stimuli associated with the trauma, numbing of general responsiveness, and persistent hyperarousal With children, PTSD probably emerges through a combination of traumatic events, along with a silent or nonaccepting environment that fails