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For clinicians

A number of randomised controlled trials (RCTs) investigating the pharmacological management of acute severe behavioural disturbance (ASBD) have been undertaken in the adult population. However, there is a dearth of evidence in the paediatric population – no RCTs or systematic reviews have been undertaken. As a result, with paediatric presentations of ASBD increasing every year, the findings from the adult RCTs have been extrapolated to this group. This is concerning, as the causes of ASBD in children are notably different from  adults. The adult medications currently being used in children are also likely to vary in their effectiveness and side effect profiles within the paediatric population.

Additionally, ASBD presentations have significant impacts on ED resources. However, the degree of resource use and the associated costs incurred have not been studied in the paediatric ASBD setting.

The PEAChY-M study aims to provide the Australasian clinical community with clear information on the most effective intramuscular medication for use in paediatric ASBD, as well as data related to healthcare resource use for and costs of paediatric ASBD presentations to ED.

The research team have undertaken an electronic survey (unpublished) of Australian adult and paediatric emergency physicians to better understand current clinical practice and clinician preferences in relation to treatment of paediatric ASBD. A total of 218 responses were received. As a result of these findings, in combination with state-based guidelines and the side-effect profiles of each medication, the study team selected IM olanzapine and IM droperidol for comparison, with 53.2% and 86.7% of respondent’s requesting they be included in the trial, respectively.