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Young children with psychiatric complaints in the pediatric emergency department
Melanie M Randall1, Karli Parlette1, Ellen Reibling1
1Emergency Department, Loma Linda University Medical Center and Children's Hospital, 11234 Anderson Street, Loma Linda, CA 92354, USA.
Insights
The number of young children with psychiatric issues in the emergency department (ED) is rising. Many of these pediatric psychiatric cases are stable for discharge, suggesting a need for better outpatient resources.
Area of Science:
- Pediatric Emergency Medicine
- Child and Adolescent Psychiatry
- Public Health
Background:
- Childhood mental illness and self-harm behaviors are increasing.
- Young children with psychiatric issues frequently utilize emergency departments (EDs).
Purpose of the Study:
- To characterize the youngest children (<10 years) presenting to the ED with psychiatric complaints.
- To understand trends in pediatric psychiatric presentations to the ED.
Main Methods:
- Retrospective chart review of children under 10 years old.
- Analysis of psychiatric consultations in a pediatric ED over four years.
Main Results:
- A rise in pediatric psychiatric visits to the ED was observed.
- Violent behavior and aggression were common presenting complaints.
- Half of the children were cleared for discharge by psychiatric consultation.
Conclusions:
- The increasing trend of young children with psychiatric complaints in the ED warrants attention.
- Enhanced urgent outpatient psychiatric services could reduce ED reliance.
- Many young patients presenting with psychiatric issues may not require hospitalization.
Introduction:
Children are increasingly diagnosed with mental illnesses and self-harm behaviors. They present frequently to the emergency department (ED) for evaluation. The aim of this study is to describe the youngest children in the ED with psychiatric issues.
Methods:
This is a retrospective chart review of all consecutive children less than 10 years of age with a psychiatric complaint who received a psychiatric consultation in the pediatric emergency department in the last four years.
Results:
The number of children with psychiatric issues increased over the study period. The ED length of stay also increased. Violent behavior and aggression were the most common chief complaints, and some children required chemical or physical restraint in the ED. Many children had pre-existing psychiatric issues and a history of adverse childhood experiences. Half of patients were deemed safe for discharge home by psychiatric consultation.
Conclusion:
The number of young children with psychiatric complaints presenting to the ED has increased. However, a large number are found to be stable for discharge home. Increase in urgent outpatient psychiatric resources could help decrease ED utilization.
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