title: What are kids getting into these days? A retrospective chart review of substance use presentations to a Canadian pediatric emergency department.
abstract: OBJECTIVE
  Goals for this study were to characterize the substances being used by youth who presented to an emergency department (ED), their demographic descriptors, and to describe the associated acute morbidity and mortality.
  
  
  METHODS
  We conducted a retrospective review of all youth, ages 10-16 years, who presented to a pediatric ED with complaints related to recreational drug use (n=641) for 2 years ending on December 31, 2009.
  
  
  RESULTS
  The median age of patients was 15 years; 56% were female. Six percent of patients were homeless, and 21% were wards of the state. The most frequent ingestions included ethanol (74%), marijuana (20%), ecstasy (19%), and medications (15%). Over one third of patients had ingested two or more substances. Ninety percent of patients were brought to the ED by the emergency medical services; 63% of these activations were by non-acquaintances. Of the 47% of youth who presented with a decreased level of consciousness, half had a Glasgow Coma Scale less than 13. The Canadian Triage and Acuity Scale score was 1 or 2 for 44% of patients. Sixty-eight percent received IV fluids, 42% received medication, and 4% were intubated. The admission rate was 9%.
  
  
  CONCLUSIONS
  Youth who presented to the ED for substance use represented a socially vulnerable population whose use of recreational substances resulted in high medical acuity and significant morbidity. Improved clinical identification of such high-risk youth and subsequent design of interventions to address problematic substance use and social issues are urgently needed to complement the acute medical care that youth receive.
authors.affiliation: *Department of Pediatrics,University of Alberta,Edmonton,AB.
authors.forename: G Emmi
authors.initials: GE
authors.lastname: Driedger
authors.affiliation: †Faculty of Medicine & Dentistry,University of Alberta,Edmonton,AB.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Dong
authors.affiliation: *Department of Pediatrics,University of Alberta,Edmonton,AB.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Newton
authors.affiliation: *Department of Pediatrics,University of Alberta,Edmonton,AB.
authors.forename: Rhonda J
authors.initials: RJ
authors.lastname: Rosychuk
authors.affiliation: *Department of Pediatrics,University of Alberta,Edmonton,AB.
authors.forename: Samina
authors.initials: S
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000416:Alberta / Q000453:epidemiology; D002648:Child; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D057985:Multi-Ingredient Cold, Flu, and Allergy Medications / Q000506:poisoning*; D010343:Patient Admission / Q000639:trends*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000453:epidemiology*; D015996:Survival Rate / Q000639:trends
chemical_list: D057985:Multi-Ingredient Cold, Flu, and Allergy Medications
keywords: adolescent; drug abuse; emergency; pediatric; substance abuse