Children and adolescents with acute alcohol intoxication/self-poisoning presenting to the emergency department.
OBJECTIVE
To describe the presentations, characteristics, and follow-up care of children and adolescents aged 10 to 18 years who present to emergency departments (EDs) with acute alcohol intoxication/self-poisoning.


METHODS
Retrospective medical record review.


METHODS
Five EDs in Western Sydney, Australia.


METHODS
Patients aged 10 to 18 years who presented to EDs with acute alcohol intoxication/self-poisoning between January 1, 1996, and December 31, 2000.


METHODS
Frequency of presentations; presentation characteristics; psychosocial characteristics; and presence or absence of follow-up.


RESULTS
Two hundred twelve children and adolescents presented to EDs 216 times. Of the 212 patients, 49 (23%) were 14 years or younger, and the youngest was aged 10 years. The majority (82%) came after hours and were brought in by emergency services (77%). In 13% of presentations, verbal and/or physical aggression was present, and a threat of self-harm was present in 2% of cases. A mental health worker was consulted about the child or adolescent in only 6% of presentations. Most children and adolescents (85%) were discharged from the ED. Of concern, in 56% of presentations, a follow-up plan was not recorded. There was documentation of mental health follow-up in only 14% of presentations and follow-up from drug and alcohol services in only 1%. Forensic history, school functioning, and a history of past mental health problems were not documented in more than 60% of the medical records examined.


CONCLUSIONS
When children or adolescents present to an ED with acute alcohol intoxication/self-poisoning, their risk factors for psychosocial dysfunction appear to be inadequately assessed, documented, and followed up. Clear guidelines for assessment and referral pathways must be established in EDs.
Woolfenden
Sue
S
Centre for the Prevention of Psychological Problems in Children Hospital, Sydney, Australia. susanw@chw.edu.au
Dossetor
David
D
Williams
Katrina
K
D000208:Acute Disease; D000223:Adaptation, Psychological; D000293:Adolescent; D000435:Alcoholic Intoxication / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D009517:New South Wales / Q000453:epidemiology; D010351:Patient Discharge; D011041:Poisoning / Q000453:epidemiology* / Q000523:psychology*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies