Citation

Cohen L, Gras-Le Guenb C, Fleury J, Caldagues E, Dréno L, Picherot G, Vabres N. Arch. Pediatr. 2017; 24(12): 1214-1219.

Vernacular Title

Agitation des adolescents dans les services d’accueil des urgences pédiatriques : problématique des cas dits « complexes ».

Affiliation

Unité d'accueil des enfants en danger, CHU de Nantes, quai Moncousu, 44093 Nantes cedex 1, France.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.arcped.2017.10.001

PMID

29153907

Abstract

INTRODUCTION: Teenagers admitted to the emergency room for a violent attacks episode are increasingly numerous. The source of agitation is multifactorial for these teenagers, often with a complex course. They jeopardize hospital wards, which are often ill-suited for and overwhelmed during these outbursts. This study aims to identify and describe all the teenagers admitted to the hospital over 1 year for a violent outburst and discuss their management.

METHODS AND EQUIPMENT: Retrospective and descriptive study of teenagers admitted to the pediatric emergency department of the Nantes University Hospital for a violent outburst in 2015.

RESULTS: During this 1-year study, 99 teenagers out of a total of 182 consultations were admitted for a violent outburst. We noted that 85% of them had a previous history of a violent outburst, 70% of them were seeing a psychologist, and 56% were followed by the child welfare services. Most of the outbursts took place at home and were hetero-aggressive. Upon arrival at the pediatric emergency ward, 90% of the teenagers had calmed down. The mean time spent in the emergency ward was 3h42min. Finally, 31% of the teenagers were hospitalized in the general pediatric unit, 14% in the children's psychiatric department, and 8% in the adult psychiatry ward.

CONCLUSION: We observed a high proportion of complex cases in the teenagers admitted to our emergency department for a violent outburst. These teenagers in distress, with a complex previous history, illustrated the relation between violence against themselves and their own violent behavior toward others. Developing short-stay units for a temporary isolation could be an advantageous multidisciplinary approach to allow somatic, psychological, and social evaluation of these vulnerable patients.

Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Language: fr