ED Pathway for Evaluation/Treatment of Children with Behavioral Health Issues

Alternatives to Restraints

General

Environmental Controls Dim lights
Play low music
A favorite TV show
Minimize noise and unnecessary activity, people in the room
Remove any potential object/equipment that could cause injury
Psychological Interventions Provide one-to-one verbal support
Involve or limit family visitation as appropriate
Implement a Safety Observation Level, explain safety and support aspects of observation
Ask eliciting questions and make uninterrupted time to listen to the patient
Remain neutral and calm
Behavioral Interventions Child Life interventions
Use simple age appropriate directions and explanations
Try verbal redirection
Consider distraction techniques
Set reasonable limits
Explain consequences of behavior in simple concrete terms
Nursing Interventions Assess patient for any physical/medical causes for behavior
Assess for the need for PRN medication
Consult MD for medication alternatives
Initiate a safety observation level, ask MD for order
Explain safety and support aspects of observation level
Consultation Psychiatry , Social Work, Charge RN, Level 4, Clinical Nurse Specialist, Nurse Manager, Clinical Nurse Specialist in Mental Health, Nursing Supervisor, Child Life