Pediatric emergency medicine trisk 4211 4211
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and discuss use of relaxation techniques. Benzodiazepines should be avoided
when possible, so as to help the patient and their family recognize that the
symptoms of a panic attack are time limited and self-resolving. If the panic
attacks are frequent, cause significant distress, or are leading the
patient/family to repeatedly seek medical care, referral to an outpatient
mental health provider is indicated. If left untreated, panic attacks can
blossom into lifelong and severely impairing anxiety disorders. However,
with appropriate and early treatment, future panic attacks and their sequelae
can be prevented.
CARING FOR CHILDREN WITH AUTISM SPECTRUM
DISORDERS IN THE EMERGENCY DEPARTMENT
Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined
by difficulties in social communication and restricted or repetitive behaviors
and interests. Individuals with ASD demonstrate challenges engaging in
social reciprocity, appreciating nonverbal social behaviors, and establishing
social relationships. Characteristically, this population exhibits highly fixed
interests and adherence to strict routines. Autism is a clinical diagnosis that
can be reliably identified as early as 2 years of age, although core deficits in
communication, social responsiveness, and play present as early as 6 to 12
months of age.
Significant heterogeneity exists in clinical phenotype, severity, type, and
frequency of symptoms. Children with ASD may lack attention, avoid eye
contact, struggle to talk about feelings, prefer not to be touched, repeat or
echo words said to them, engage in repetitive actions, have trouble
expressing needs in typical words or behaviors, display anxiety with changes
in routine, and demonstrate exaggerated distress to modest sensory
experiences. Degree of disability is generally related to the level of support
needed in school and with daily functioning.
The biology of ASD is incompletely understood as a disorder of neuronalcortical organization reflecting both genetics and environmental influences.
ASD affects all racial, ethnic, and sociodemographic populations, with
disproportionately higher rates among boys and later identification in
minority groups. A 2014 prevalence study by the Centers for Disease
Control reports overall 1 in 59 children (1 in 37 boys and 1 in 151 girls)
