<p>Algorithm for PRN sedation in ADOLESCENTS with behavioural disturbance. Consider non-drug strategies, If behaviour continues to pose risk to self or others …</p><p>Non-drug strategies. Drug strategies</p><p>1. Consider NON-DRUG measures first which include Adolescents have developing brains and de escalation techniques such as talking down, are vulnerable to side effects e.g distraction and giving clear requests. Do not rush disinhibition due to the use of and remain calm and reassuring. benzodiazepine medication. 2. Consider the environment and change the environment if it seems unsafe, cluttered or adding When prescribing any medication for to distress i.e ensure it is low stimulus sedation it is important to document Date and time given 3. Consider any physical illness that maybe impacting Medication given on behaviour Who initiated the administration What was the reason for administration 4. Consider the impact that illegal substances might be Was this in relation to an aggressive or having on a young person’s behaviour including violent incident Was an incident report required (and alcohol withdrawal Datix number) Medication review after 30 minutes and to what extent did the medication make a difference to the presentation</p><p>Consider oral therapy </p><p> lorazepam 1-2mg (max 4-8mg/24hrs) onset of action 20-40 mins</p><p>Record if medication worked Continue talking and using non-drug approaches Including identifying triggers Wait 30-45 minutes then if no benefit. Lorazepam</p><p>Repeat dose if necessary. Sedation in 30-45 minutes, peak plasma concentration in 2 hours</p><p>Continue talking and using non-drug approaches Physical monitoring should be carried out as per the paediatric guidelines on sedation. Possible respiratory depression with benzodiazepines. Flumazenil must be at hand.</p>