UMEM Educational Pearls

Category: Pediatrics

Title: Administration of psychotropic medications in the pediatric emergency department

Keywords: mental health, sedation, home medications (PubMed Search)

Posted: 7/19/2024 by Jenny Guyther, MD (Updated: 7/22/2024)
Click here to contact Jenny Guyther, MD

Emergency department visits for pediatric mental health and behavioural concerns have been increasing.  This study attempted to further characterize medications, both home and for sedation, that were given to these patients.  

This study included 670,911 youth with a mental or behavioral health diagnosis over a 9 year inclusion period.  The most common diagnses were depressive disorder, suicide or self injury and disruptive, impulse control and conduct disorder.  During this time, a total of 12.3% of patients had a psychotropic medication given while in the ED.  The percentage and odds of administering these medications increased from 7.9% in 2013 to 16.3% in 2022.  Those with intellectual disability and autism spectrum disorder had the highest frequency of medication administration.  

Bottom line: As mental health visits in pediatrics continue to increase along with boarding times, clinicians should become more familiar with psychotropic medications used in this population and become comfortable in making sure that these patients have their home medications and have a plan for chemical sedation if other areas of de escalation fail.