The adult patient in the pediatric emergency department

Baker, M. Douglas; Schwartz, Gary; Ludwig, Stephan

doi:10.1016/s0196-0644(05)80978-3

Cited by 13 publications

(18 citation statements)

References 1 publication

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“…1,[3][4][5] This likely represents different age cutoffs in the North American PEDs. 1,[3][4][5] This likely represents different age cutoffs in the North American PEDs.…”

Section: Discussionmentioning

confidence: 99%

“…1,[3][4][5] This may reflect the ease of access to the hospital. In comparison, Hayes et al 1 reported triage categories as urgent or emergent in 87% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Similarly, injuries accounted for the largest proportion of provisional diagnoses. Altered conscious state (which was predominantly caused by syncope) and chest pain/syncope comprised 8.3% of the presentations.…”

Section: Discussionmentioning

confidence: 99%

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Too Long in the Tooth

Kibar

Borland

2006

Pediatric Emergency Care

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Adult presentations were not infrequent. Twenty patients (41.7%) were within 1 year of the age cutoff at Princess Margaret Hospital. Although 45.8% of presentations had a low acuity, the majority of patients had Australasian Triage Scale scores of 2 or 3. The presentations were heterogeneous in nature, with injuries accounting for a large proportion. Most patients were referred for further care, but a minority were not compliant with follow-up instructions. There was a low admission rate.

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“…1,[3][4][5] This likely represents different age cutoffs in the North American PEDs. 1,[3][4][5] This likely represents different age cutoffs in the North American PEDs.…”

Section: Discussionmentioning

confidence: 99%

“…1,[3][4][5] This may reflect the ease of access to the hospital. In comparison, Hayes et al 1 reported triage categories as urgent or emergent in 87% of patients.…”

Section: Discussionmentioning

confidence: 99%

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Too Long in the Tooth

Kibar

Borland

2006

Pediatric Emergency Care

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“…While PEM fellowship programs are currently required to provide a minimum of 4 months of experience in adult EM, graduates who go on to practice in pediatric EDs will have the opportunity to manage few adult patients. A 2-year study in one pediatric ED reported that 0.01% of all visits were by adults (10). Although we support the continued need to train PEM specialists to recognize and manage acute illnesses in adults, we see an even greater urgency to equip the same physicians with the knowledge to recognize and manage the needs of the more substantial number of children who present with acute psychiatric-related illnesses.…”

Section: Discussionmentioning

confidence: 68%

Emergency medicine training programsʼ educational requirements in the management of psychiatric emergencies

Santucci

Sather

Baker

2003

Pediatric Emergency Care

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“…While adults presenting to pediatric emergency departments or admitted to pediatric hospitals have been described 612 , to our knowledge, the extent to which and under what circumstances adults are admitted to pediatric intensive care units (PICUs) has not been addressed. Neither has there been a description of their clinical characteristics or outcomes.…”

Section: Introductionmentioning

confidence: 99%

Multi-institutional Profile of Adults Admitted to Pediatric Intensive Care Units

et al. 2013

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Importance Growing numbers of persons with childhood-onset chronic illnesses are surviving to adulthood. Many use pediatric hospitals for their inpatient needs. To our knowledge, the prevalence and characteristics of adult pediatric intensive care unit patients have not been reported. Objectives To estimate the proportion of adults admitted to pediatric intensive care units (PICUs), characterize them, and compare them with older adolescents. Design One-year cross-sectional analysis. Setting Pediatric intensive care units in the United States that participated in the Virtual Pediatric Intensive Care Unit Systems. Participants Pediatric intensive care unit patients 15 years or older admitted in 2008. Main Outcome Measures We compared adults with adolescents across clinical characteristics and outcomes. Mixed-effects logistic regression was used to estimate the independent association of age with PICU mortality. Results Seventy PICUs had 67 629 admissions; 1954 admissions (2.7%) were patients 19 years or older; and 9105 admissions (13.5%) were patients aged 15 to 18 years. The proportion of adults (_19 years) varied considerably by PICU (range, 0%–9.2%). As age increased, the proportion of patients who had a complex chronic condition and planned or perioperative admissions increased; the proportion of trauma-related admissions decreased. Patients aged 21 to 29 years had a 2 times (95% CI, 1.3–3.2; P=.004) greater odds of PICU mortality compared with adolescent patients, after adjusting for Paediatric Index of Mortality score, sex, trauma, and having a complex chronic condition. Being 30 years or older was associated with a 3.5 (95% CI, 1.3–9.7; P=.01) greater odds of mortality. Conclusions and Relevance In this multi-institutional study, adults constituted a small but high risk proportion of patients in some PICUs, suggesting that these PICUs should have plans and protocols specifically focused on this group.

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The adult patient in the pediatric emergency department

Cited by 13 publications

References 1 publication

Too Long in the Tooth

Too Long in the Tooth

Emergency medicine training programsʼ educational requirements in the management of psychiatric emergencies

Multi-institutional Profile of Adults Admitted to Pediatric Intensive Care Units

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