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Prehospital Management of Pediatric Behavioral Health Emergencies: A Scoping Review

Elizabeth V Zorovich1, Kathryn Kothari2, Kathleen Adelgais3

  • 1Pediatric Emergency Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.

Cureus
|June 12, 2023
PubMed

Insights

Pediatric behavioral health emergencies are rising, but prehospital guidelines are lacking. This review highlights the urgent need for more research and standardized protocols for managing these critical pediatric cases.

Area of Science:

  • Emergency Medicine
  • Pediatrics
  • Public Health

Background:

  • Pediatric behavioral health emergencies (BHE) are increasingly prevalent.
  • There is a significant gap in evidence-based guidelines for prehospital management of pediatric BHE.

Purpose of the Study:

  • To identify existing research and publicly available emergency medical services (EMS) protocols for prehospital pediatric BHE.
  • To determine future research priorities and inform EMS protocol development for children with neurodevelopmental conditions.

Main Methods:

  • A scoping review was conducted, searching literature from 2012-2022 and publicly available US EMS protocols.
  • Included studies and protocols focused on pediatric BHE epidemiology or prehospital management.
  • Screened 50 publications and protocols; seven publications and four protocols were included.

Main Results:

  • Research confirms a rise in pediatric BHE over the past decade.
  • Few studies (n=4) addressed current prehospital management.
  • Only two EMS protocols were specific to pediatric BHE; others included pediatric considerations within adult protocols.
  • All reviewed protocols favored non-pharmaceutical interventions before pharmacologic restraints.

Conclusions:

  • Despite increasing pediatric BHE, research and clinical EMS protocols are scarce.
  • There is a critical need for developing evidence-based best practices for prehospital pediatric BHE management.
  • Future research should focus on informing these essential best practices.

Keywords:
behavioral health emergenciesemergency medical servicespediatric behavioral health emergencypediatric emergency medicineprehospital management

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