Diagnostic approach to acute onset psychosis in children

HF: heart failure; SLE: systemic lupus erythematosus.

* Attempt verbal deescalation. Progress to physical restraints, as needed. Check rapid blood glucose, provide empiric oxygen therapy. Administer chemical restraint as needed (refer to UpToDate text).

¶ Other laboratory studies should be obtained if a diagnosis has not been made at this point and may include a complete blood count, liver enzymes (eg, aspartate aminotransferase [AST], alanine aminotransferase [ALT], lactate dehydrogenase [LDH], alkaline phosphatase), liver function tests (total protein, albumin, total and direct bilirubin, prothrombin time, and activated thromboplastin time) ammonia, serum electrolytes, serum blood urea nitrogen and creatinine, and thyroid function tests. Additional testing for inborn errors of metabolism or SLE is indicated in selected patients with specific physical findings (refer to UpToDate text).