should allow patients to feel some control over their current situation Creating a space where the child feels safe, giving them choices when possible, and actively listening may improve care It helps providers maintain compassion when dealing with children that, on the surface, seem challenging or antagonistic Implementing such care usually requires careful negotiations with patient, as well as planning and flexibility by ED clinicians Clinical Considerations Clinical Recognition Agitation may manifest in a wide variety of behaviors, depending on the patient’s age and developmental and physical state Signs and symptoms may include restlessness, hyperactive motor activity, confusion or disorientation, uncontrollable crying, verbal threats, and overt physical violence toward oneself, others, or physical property Triage A patient who is mildly agitated or who presents for evaluation of threats of harm may be able to wait safely in an ED waiting room and may benefit from de-escalating strategies However, care should be taken to monitor these patients for signs of escalation and to prevent elopement A thorough search of persons and belongings should be performed Actively/potentially violent or highly agitated patients require immediate transition to a secure area of the ED that is under the constant observation of hospital personnel Security staff should be used whenever patients have the potential for significant violence or aggression