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Hello esteemed colleagues,

Recently, we have had a few difficult cases involving children with ASD in our ED that have motivated our leadership to come up with a more systematic approach to care for these kids.  Not infrequently, parents will bring their children to our ED with significant behavioral issues when they feel they are out of options.  These children at times escalate and require management strategies to help keep the patients and our staff safe.  We currently have a mental health pathway that we use to guide the care of patients with agitation for any reason, but we don't have anything specifically for patients with autism.  I was hoping to tap into the expertise of this group to see how things are handled in your hospital.  Particularly:

1. Do you have dedicated physical space to care for these patients in your ED?  If not, what solutions have you devised?

2. Is your hospital willing to admit these patients to the ward?

3. Do you have a standard de-escalation/treatment pathway that you utilize when caring for these patients?

4. Do you require parents to be present at all times while the patient remains in the ED?

Thank you ahead of time for your insights!

Beech Burns
Pediatric Emergency Medicine
Oregon Health and Science University

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