Characteristics That Distinguish Adolescents Who Present to a Children's Hospital Emergency Department From Those Presenting to a General Emergency Department

Abstract

When a children's and general ED are in close proximity, there are unique characteristics of the adolescents at each site. Understanding the differences can assist clinicians to provide care tailored to meet the needs of each group.

Older adolescent presentations to a children's hospital emergency department

“…Injury and abdominal pain as the two most common diagnoses for older adolescents presenting to paediatric ED was a findings consistent with other studies. 2,[4][5][6][7] Only one-third of the females diagnosed with unspecified abdominal pain were tested for pregnancy. It is possible that ED staff do not consider pregnancy as a differential diagnosis or are uncomfortable taking a sexual history from young women, 23 particularly if parents are present.…”

“…2 Other studies confirm injury as the most likely reason for presentation by adolescents to a paediatric ED, 5,6 and injuries along with abdominal pain were the most common causes for adolescent presentations to general EDs. 4,6,7 The majority of the adolescents presenting to EDs were triaged as non-urgent or low acuity. 6,7 Specific developmental health needs mean that adolescents offer unique challenges to the staff in ED.…”

“…4,6,7 The majority of the adolescents presenting to EDs were triaged as non-urgent or low acuity. 6,7 Specific developmental health needs mean that adolescents offer unique challenges to the staff in ED. Studies have shown that doctors in paediatric practice feel uncomfortable when dealing with adolescents.…”

Adolescent presentations to an adult hospital emergency department

“…5 In the literature, adolescents make up approximately 15% of presentations to paediatric EDs 6 and 16-20% of presentations to general EDs. 7,9,10 Presentations for acute deterioration in chronic illness due to therapy non-adherence, and for substance use are likely to be relevant for older adolescents. 8 Adolescents present to adult EDs mostly for injuries and problems relating to musculoskeletal, respiratory and digestive systems.…”

“…8 Adolescents present to adult EDs mostly for injuries and problems relating to musculoskeletal, respiratory and digestive systems. 7,9,10 Presentations for acute deterioration in chronic illness due to therapy non-adherence, and for substance use are likely to be relevant for older adolescents. 4 Adolescent use of emergency services is high compared to their use of primary care services.…”