ED Pathway for Evaluation/Treatment of Children with Behavioral Health Issues

Brief History and Physical

General

Avoid repeat interviews, physical exams whenever possible
Briefly research PMH, developmental history in EPIC
Explain the ED visit, make sure to explain what to expect, procedures, etc.
Frequent updates are imperative

  Psychiatric Complaints Developmental Issues
HPI Brief description of reason for visit
Depression symptoms
Suicidal ideation
Auditory hallucinations
Behaviors leading to unsafe environment
Symptoms concerning for organic disease
Determine ways to de-escalate
Brief description of reason for visit
Review agitation triggers (general + hospital specific) Behaviors leading to unsafe environment
Determine ways to de-escalate
Determine optimal methods of mutual communication
Methods of determining presence, severity of pain
PMH Medical diagnoses
Previous hospitalizations (medical, psychiatric)
Outpatient therapy
Medical diagnoses
Hospitalizations
Development Current diagnoses Current diagnoses
Medications Prescription, OTC Prescription, OTC
ROS Focus neurologic, endocrine disease Focused on chief complaint
PE Skin exam for injury
Signs of organic disease
Focused on chief complaint