@article{ref1,
title="Factors associated with paediatric and adolescent emergency department presentations involving acute behavioural disturbance events",
journal="Journal of Paediatrics and Child Health",
year="2021",
author="Lovett, Caitlyn J. and Hiles, Jo-Anne and Calver, Leonie and Pallas, Jeremy D. and Thomson Bowe, Katherine and Downes, Michael A.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="AIM: Studies reporting factors associated with paediatric/adolescent acute behavioural disturbance (ABD) in the Emergency Department (ED) are lacking. The aim of this study is to describe paediatric/adolescent ED presentations involving ABD events. <br><br>METHODS: A retrospective chart review of presentations involving ABD events, identified via hospital security log, to a tertiary referral paediatric ED during the 2017 calendar year. Data reported included: cause of presentation, use of sedation/physical restraint, ED/inpatient length of stay (LOS) and time requiring security staff presence. <br><br>RESULTS: From 280 reported ABD episodes 26 were excluded leaving 254 events involving 150 patients across 233 presentations of whom 38 (25.3%) presented on multiple occasions. Median age was 14 years (interquartile range (IQR): 13-16), 132/233 (56.7%) were female, 167/233 (71.7%) primary mental health complaints, 30/233 (12.9%) deliberate self-harm, 18/233 (7.7%) deliberate self-poisoning, 11/233 (4.7%) acute intoxication and 7/233 (3.0%) other. Transport to hospital involved police and ambulance in 124/233 (53.2%), ambulance only 71/233 (30.5%), police only 16/233 (6.9%), relative or carer 20/233 (8.6%), with self-presentation in 2/233 (0.9%). Sedation or physical restraint was used in 81/233 (34.8%), both 38/233 (16.3%), restraint only 26/233 (11.2%) and sedation only 17/234 (7.3%). Intra-muscular droperidol accounted for 57/96 (59.4%) sedations, IM/IV benzodiazepines 15/96 (15.6%), IM/IV ketamine 5/96 (5.2%) and 19/96 (19.8%) other. Discharge from ED occurred in 171/233 (73.1%) with median ED LOS 5.1 h (IQR: 3.5-7.7) and median hospital LOS 92.4 h (IQR: 47.5-273.4) for those admitted. The Mental Health Act was utilised in 183/233 (78.5%) presentations. Median security staff time requirement per presentation was 2.4 h (IQR: 1.0-3.9). <br><br>CONCLUSIONS: Paediatric/adolescent ED presentations involving ABD are primarily due to mental health complaints. Less than half require the use of sedation/physical restraint. Time requiring security staff involvement is a significant resource consumption.<p /> <p>Language: en</p>",
language="en",
issn="1034-4810",
doi="10.1111/jpc.15668",
url="http://dx.doi.org/10.1111/jpc.15668"
}