Dealing with acutely disruptive children in hospital

Disruptive children in a paediatric setting can be difficult to manage, can make treatment decisions more complex and put the young person, parents and staff at risk. Risks include delayed or incomplete treatment, and physical harm to the patient, parent or staff members. Anxiety generated around a young person acting in a disruptive way can further escalate the problem. Being aware of the systemic impact of disruptive behaviour is an important first step in managing it. Whilst there are legal frameworks to help manage the acutely disruptive patient, each case needs to be considered on its merits. The Mental Health Act is not always the most relevant legal framework and its implementation does not normally enable the responsible clinician to treat a physical illness. Maximizing use of play specialists and creating a suitable environment can reduce the need for restraint and medication, which should be used with caution and only with adequate training.