Respondents reacted negatively to the idea of emergency care personnel approaching them at the hospital and engaging them in discussions of violence or personal safety (Dowd et al., 2000). This finding presents a real challenge to emergency care providers since teens often present with conditions resulting from violence or alcohol or drug use. Most EDs do not provide preventive screenings or counseling for adolescents (Wilson and Klein, 2000). Physicians tend to find adolescent patients “frustrating,” and according to one study, adolescents receive less-than-optimal care in the emergency room (March and Jay, 1993). Yet brief interventional counseling for adolescents may be of value. A prevention effort at one ED targeting injured adolescents resulted in greater use of seat belts and bicycle helmets (Johnston et al., 2002).

Certainly more research is necessary to provide adolescents with emergency services in a way that is both patient-centered and effective. Clearly, however, an understanding of the psychosocial and developmental issues that characterize adolescence may help staff respond more effectively to adolescent patients (March and Jay, 1993).

SUMMARY OF RECOMMENDATIONS

5.1 The Department of Health and Human Services should fund studies of the efficacy, safety, and health outcomes of medications used for infants, children, and adolescents in emergency care settings in order to improve patient safety.


5.2 The Department of Health and Human Services and the National Highway Traffic Safety Administration should fund the development of medication dosage guidelines, formulations, labeling guidelines, and administration techniques for the emergency care setting to maximize effectiveness and safety for infants, children, and adolescents. Emergency medical services agencies and hospitals should incorporate these guidelines, formulations, and techniques into practice.


5.3 Hospitals and emergency medical services agencies should implement evidence-based approaches to reducing errors in emergency and trauma care for children.


5.4 Federal agencies and private industry should fund research on pediatric-specific technologies and equipment for use by emergency and trauma care personnel.


5.5 Emergency medical services agencies and hospitals should integrate family-centered care into emergency care practice.



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