> From: [log in to unmask]
> Date sent: Mon, 15 May 2000 15:16:54 EDT
> Subject: Pediatric psychiatric pt in the ER
> To: [log in to unmask], [log in to unmask]
> Hello. I am an admin supervisor of a 400+bed level 2 hosp on the
> southcoast of Mass. We seem to have had an influx of pedi psych cases
> in our busy ER (70,000+ visists per yr). We've had children age 5-14
> waiting 24-36 hrs for a pedi psych in-pt bed at another facility. We
> have an adult locked psych unit but are not licensed for under 16 yrs
> old. These kids have created an unique problem for our ER staff. We
> need to keep them safe but we are not set up to hold pts for days to
> await placement. You can imagine a holiday weekend waiting for a
> pedi psych bed to open. What a nightmare. We are being told by the
> Crisis Center and Pysch Triage that there are so few pedi/adol beds
> in our area.
> Are other parts of the country seeing the same influx?? How are they
> handling it in their ER's. Do you have any suggestions??? These kids
> present with violent behaviors, suicidal plans with serious attempts.
> Unlike their adult counterparts, they don't have alcohol or
> polysubstance related attempts. These kids seem to have straight
> forward psychiatric problems. Thanks for any input.
> Jan DeValles, RN, CEN, BA 1 Hedge ST Fairhaven, Ma 02719 Admin
> Supervisor Southcoast Hosp Groups 101 Page St New Bedford, Ma 02740 -
> [log in to unmask]
Welcome to the world of emergency medicine. This is an every day
occurrence in ED's in AZ where we have a poor system of mental health
services. I've always been told MA had one of the best systems of mental
health in the country. Is this not the case?
We routinely hold peds and adult patients for up to a day while the
psychiatrists, health plans, psych facilities, and others stonewall us
regarding transfer and admission. It's very convenient since the ED has
become the dumping ground of society. Don't know what to do with a
patient. It's easy, just send them to the ED.
I don't know your background, and I certainly don't mean to appear
flippant, but we've been fighting this battle for years and years. If
this is just now becoming an issue in your ED then you've been fortunate
up to this point.
Daniel E. Kates, M.D.
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