SAQ 298 – Paediatrics – autism, agitation and elbow injury

Paediatrics – autism, agitation and elbow injury.

a. Non-pharmacological measures

• Engage parents or usual carers.
• Use distraction, play therapy, or a child-life/play specialist.
• Minimise unnecessary examination, procedures, noise, and stimulation.
• Use the same experienced staff where possible.
• Provide familiar objects, communication aids, weighted blanket, music, or headphones.
• Attend to basic needs such as hunger, thirst, warmth, toileting, and pain.
• Use de-escalation and offer choices or a sense of control.

b. Medication-choice factors

• Current medications and possible interactions.
• Previously effective or poorly tolerated medicines.
• Allergies.
• Clinical area and staff capacity for observation and safety.
• Comorbidities or risks such as long QT, difficult airway, respiratory infection, or other medical history.
• Preferred route and distress caused by administration.
• Whether the aim is analgesia, sedation, or both.
• Local guideline familiarity and availability.
• Severity of limb injury and urgency of imaging/reduction.
• Parental consent, preferences, and agitation severity.

c. X-ray findings

• Medial epicondyle avulsion fracture.
• Raised anterior fat pad/joint effusion.
• Soft tissue swelling.
• Anterior humeral line does not intersect the capitellum normally.