Saidinejad, MohsenFoster, Ashley A.Santillanes, GenevieveLi, JoyceWallin, DinaBarata, Isabel A.Joseph, MadelineRose, EmilyCheng, TabithaWaseem, MuhammadBerg, KathleenHooley, GwendolynRuttan, TimothyShahid, SamLam, Samuel H. F.Amanullah, SirajLin, SophiaHeniff, Melanie S.Brown, KathleenGausche-Hill, MarianneACEP Pediatric Emergency Medicine Committee2024-10-152024-10-152024-08-23Saidinejad M, Foster AA, Santillanes G, et al. Strategies for optimal management of pediatric acute agitation in emergency settings. J Am Coll Emerg Physicians Open. 2024;5(4):e13255. Published 2024 Aug 23. doi:10.1002/emp2.13255https://hdl.handle.net/1805/43963Acute agitation in youth is a challenging presentation to the emergency department. In many cases, however, youth can be behaviorally de-escalated using a combination of environmental modification and verbal de-escalation. In cases where additional strategies such as pharmacologic de-escalation or physical restraint are needed, using the least restrictive means possible, including the youth in the decision-making process, and providing options are important. This paper reviews specific considerations on the approach to a youth with acute agitation and strategies and techniques to successfully de-escalate agitated youth who pose a danger to themselves and/or others.en-USAttribution-NonCommercial-NoDerivatives 4.0 InternationalAgitationEnvironmental modificationLeast restrictive meansNeurodivergentRestraint useVerbal de‐escalationArticle