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Item Strategies for optimal management of pediatric acute agitation in emergency settings(Wiley, 2024-08-23) Saidinejad, Mohsen; Foster, Ashley A.; Santillanes, Genevieve; Li, Joyce; Wallin, Dina; Barata, Isabel A.; Joseph, Madeline; Rose, Emily; Cheng, Tabitha; Waseem, Muhammad; Berg, Kathleen; Hooley, Gwendolyn; Ruttan, Timothy; Shahid, Sam; Lam, Samuel H. F.; Amanullah, Siraj; Lin, Sophia; Heniff, Melanie S.; Brown, Kathleen; Gausche-Hill, Marianne; ACEP Pediatric Emergency Medicine Committee; Emergency Medicine, School of MedicineAcute 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.