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Behavioural emergencies in a paediatric hospital environment
Marijke Mitchell1,2,3,4, Fiona Newall1,2,3,5, Katrina Williams2,4
1Neurodevelopment & Disability, Nursing Research, Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Pediatric behavioral emergencies are rising globally, with a few children causing many incidents. Many of these children have autism spectrum disorder, intellectual disability, or psychiatric comorbidities, necessitating new intervention strategies.
Area of Science:
- Pediatric healthcare
- Behavioral emergencies
- Child psychology
Background:
- Global increase in aggression and high-risk behaviors among children in pediatric hospitals.
- Limited research on behavioral emergencies in pediatric acute care settings.
Purpose of the Study:
- To describe the characteristics and impact of behavioral emergencies in a quaternary pediatric hospital.
- To identify patient populations frequently involved in these incidents.
Main Methods:
- Retrospective study over one year.
- Analysis of behavioral emergencies requiring emergency response team (ERT) attendance.
- Data collected from a quaternary pediatric hospital.
Main Results:
- 218 children triggered 1050 behavioral emergencies in 2018, consuming 386 hours of ERT time.
- 15% of children (33) accounted for over five activations each (6-272).
- Nearly half of frequent-incident children had autism spectrum disorder or intellectual disability; over 80% had psychiatric comorbidities.
Conclusions:
- Behavioral emergencies pose risks to staff, patients, and families.
- Recurrent incidents occur despite resource allocation, indicating a need for improved management.
- Novel approaches for prevention and amelioration of pediatric behavioral emergencies are essential.
Aim:
Aggression and high-risk behaviours triggered by children in paediatric hospitals are increasing globally. There is a paucity of research describing behavioural emergencies in paediatric acute care settings.
Methods:
We conducted a 1-year retrospective study of behavioural emergencies that triggered an emergency response team attendance in a quaternary paediatric hospital.
Results:
In 2018, 218 children triggered 1050 behavioural emergencies, which utilised 386 h of the emergency response team time. Thirty-three (15%) children triggered more than five activations each (range 6-272) and nearly half (16) were children with autism spectrum disorder or intellectual disability. More than 80% of children who triggered an emergency team response also had at least one psychiatric co-morbidity.
Conclusions:
Behavioural emergencies, by definition, put staff, children or their families at risk. They occur frequently in hospital with some children repeating these behaviours despite allocation of resources and expertise. New approaches to prevention and amelioration are needed.
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