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Children who harm themselves: development of a paediatric emergency department triage tool
C Dieppe1, B Stanhope, K Rakhra
1Emergency Department, Birmingham Children's Hospital NHS Trust, Steelhouse Lane, Birmingham, UK. Clared1@chw.edu.au
Insights
A new 14-point triage tool effectively screens young people presenting with self-harm in emergency departments. This tool aids healthcare professionals in assessing suicide risk, substance misuse, and physical issues for better care.
Area of Science:
- Pediatric Emergency Medicine
- Child and Adolescent Mental Health
- Public Health
Background:
- Self-harm among children and adolescents is a significant public health concern, with over 60,000 young people presenting to UK emergency departments annually.
- Existing triage methods are not adequately tailored for the specific needs of pediatric populations experiencing self-harm.
Purpose of the Study:
- To develop and describe a specialized pediatric triage tool for young people presenting with self-harm.
- To address the need for a user-friendly tool integrating acute care, primary care, and mental health services.
Main Methods:
- A multidisciplinary team (nursing, managerial, medical staff) from pediatric emergency and child/adolescent mental health services collaborated.
- Literature review on suicide risk, substance misuse, and physical issues in pediatric self-harm.
- Development of a triage tool focusing on key risk factors and common presentations.
Main Results:
- A 14-point triage/screening tool was created, incorporating a modified suicide risk questionnaire and the CRAFFT questionnaire.
- Three additional questions address physical manifestations of self-harm.
- The tool utilizes simple, dichotomous (yes/no) answers for ease of use.
Conclusions:
- The developed pediatric triage tool facilitates more appropriate and efficient assessment of young people who self-harm.
- The tool is acceptable to all healthcare professionals involved in the care of these patients.
Introduction:
Children who harm, hurt or kill themselves are a significant issue for health professionals in emergency departments (ED), with over 60 000 young people presenting to ED in the UK each year following self-harm.
Methods:
In response to the development of a regional integrated pathway for the management of self-harm encompassing acute care, primary care and child and adolescent mental health services, it was felt that a triage tool developed specifically for children and young people presenting with self-harm was required. A multidisciplinary group encompassing nursing, managerial and medical staff from both paediatric emergency and child and adolescent mental health services was convened to determine the priorities for this tool. In this paper the development of this paediatric-specific triage tool is discussed focusing on suicide risk, substance misuse and physical issues associated with the common presentations of self-harm in young people. The available literature is also reviewed and the multidisciplinary approach to developing a user-friendly tool is discussed.
Results:
A modified risk of suicide questionnaire, the CRAFFT questionnaire, and three questions about physical manifestations of self-harm were used to form a 14-point triage/screening tool, requiring only yes/no answers.
Conclusion:
A paediatric triage tool was developed that allows the more appropriate triage of young people who harm themselves and is acceptable to all stakeholders involved in their care.
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