{"pk":12457,"title":"Pediatric Patients with Behavioral Emergencies: Who’s Coming in and What Happens While They’re Here?","subtitle":null,"abstract":"Introduction: \nChildren and adolescents evaluated in the emergency department (ED) represent a vulnerable population, especially when presenting for psychiatric symptoms. For these patients the ED environment may be stressful and lacking in needed resources. Data describing children seen within the ED are currently limited; this study aims to describe the pediatric patient population treated for mental health concerns within one ED, which may promote better-tailored treatment and support resources in the future.\n \nMethods: \nThe study describes 339 visits generated over two months in 2017 at LAC+USC Medical Center. We reviewed charts to determine each child’s stated age and gender, as well as whether the patient belonged to one or more vulnerable subpopulations. The factors of interest included involvement with the social services and legal systems, history of psychological trauma, diagnoses of post-traumatic stress disorder (PTSD) or autism spectrum disorder (ASD), and whether the patient required a “behavioral code” during his or her visit.\n \nResults: \nThe study determined that 76.1% of the charts included at least one risk factor assessed during our review. Males were more likely than females to present by the age of 11, while the opposite was true for patients age 12-17. We also determined that 38% of patients had been involved with child protective services, or a regional center (system for individuals with developmental disabilities), or the juvenile justice system, and that 5.6% were involved with multiple systems. Two hundred twenty-five patients had experienced psychological trauma, with 30 patients carrying an official diagnosis of PTSD. Of behavior codes called, 23% were for ASD patients, with these patients being far more likely to display dangerous behaviors in the ED compared with neurotypical children.\n \nConclusion: \nThis study demonstrates that a majority of children evaluated in our ED for psychiatric concerns also belonged to at least one vulnerable subpopulation. Especially striking was that behavioral codes were far more likely to be called for ASD patients than neurotypical patients, implying that EDs that work with this population may benefit from extra training in preventing and managing agitated behavior in children with ASD.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8b506481","frozenauthors":[{"first_name":"Anthony","middle_name":"R.","last_name":"Sanchez","name_suffix":"","institution":"Keck School of Medicine of University of Southern California, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Jason","middle_name":"","last_name":"Sterris","name_suffix":"","institution":"Keck School of Medicine of University of Southern California, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Erica","middle_name":"Z.","last_name":"Shoemaker","name_suffix":"","institution":"Keck School of Medicine of University of Southern California, Department of Emergency Medicine, Los Angeles, California","department":"None"}],"date_submitted":"2019-01-23T20:23:36Z","date_accepted":"2019-01-23T20:23:36Z","date_published":"2019-02-28T20:57:10Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12457/galley/6614/download/"}]}