• Joan S Bregstein, Anju M Wagh, and Daniel S Tsze.
• Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Columbia University College of Physicians and Surgeons, New York, NY. Electronic address: jsb61@cumc.columbia.edu.
• Ann Emerg Med. 2020 Jan 1; 75 (1): 86-89.

AbstractThe treatment of severe agitation, aggression, and violent behavior in behavioral health patients who present to the emergency department (ED) often requires the intramuscular administration of a sedative. However, administering an intramuscular sedative to an uncooperative patient is associated with the risk of needlestick injuries to both patients and health care providers, and times to onset of sedation range from 15 to 45 minutes. Intranasal absorption is more rapid than intramuscular, with sedatives such as lorazepam reaching peak serum concentrations up to 6 times faster when administered intranasally. We present the first report of using intranasal lorazepam as a needle-free method of providing rapid and effective sedation to treat severe agitation in a pediatric behavioral health patient presenting to the ED.Copyright © 2019 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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