A 9-year-old boy is brought in by his foster mother because “I can’t handle him anymore”. She describes his screaming, cursing, and refusing to do anything she asks. Today he burst into rage, kicking her and throwing objects: “I hate you!”, “I just want to die!”, and “My head is gonna explode!”.
The child has been living with this foster mother for the past month, and she knows little of his past medical history, other than “he is bipolar, has ADHD, and has obsessive-compulsive disorder”. The child is on risperidone, depakote, and methylphenidate. His foster mother leaves briefly to recover an item in her car.
In the ED, the child is sitting quietly eating a snack. His vital signs are normal,
and his head-to-toe physical examination is normal.
During the ED course the child becomes agitated, attempting to leave, cursing, kicking, and is unresponsive to a concerted effort in verbal and situational de-escalation. A decision to restrain the child chemically is made.
Of the following medications, which is the best first-line treatment in this agitated child?
A. Antihistamine
B. Typical antipsychotic
C. Atypical antipsychotic
D. Benzodiazepine
In the meantime, a few quotes –
“Strategy without tactics is the slowest route to victory. Tactics without strategy
is the noise before defeat.”
― Sun Tzu (544–496 BC), Zhou dynasty general and philosopher
…and…
“Be kind, for everyone you meet is fighting a harder battle.”
― Plato (428–347 BC), Classical Greek philosopher
The child has been living with this foster mother for the past month, and she knows little of his past medical history, other than “he is bipolar, has ADHD, and has obsessive-compulsive disorder”. The child is on risperidone, depakote, and methylphenidate. His foster mother leaves briefly to recover an item in her car.
In the ED, the child is sitting quietly eating a snack. His vital signs are normal,
and his head-to-toe physical examination is normal.
During the ED course the child becomes agitated, attempting to leave, cursing, kicking, and is unresponsive to a concerted effort in verbal and situational de-escalation. A decision to restrain the child chemically is made.
Of the following medications, which is the best first-line treatment in this agitated child?
A. Antihistamine
B. Typical antipsychotic
C. Atypical antipsychotic
D. Benzodiazepine
In the meantime, a few quotes –
“Strategy without tactics is the slowest route to victory. Tactics without strategy
is the noise before defeat.”
― Sun Tzu (544–496 BC), Zhou dynasty general and philosopher
…and…
“Be kind, for everyone you meet is fighting a harder battle.”
― Plato (428–347 BC), Classical Greek philosopher
RSS Feed