Trends in pediatric emergency medicine: Focus on behavioral health, substance use, and safety.

Purpose: Recent studies have indicated that medication errors, behavioral health emergencies, and substance use remain a significant concern for children and adolescents within and outside the emergency department (ED). This clinical review will evaluate recent trends and literature to provide guidance for these specific areas of concern, with an emphasis on optimizing pharmacotherapeutic care in this high-risk population.

Summary: National surveys have demonstrated that the quality of pediatric emergency care varies significantly across the US and most children are treated in EDs within nonchildren's hospitals by providers without specialized training in pediatrics. Variations in care quality emphasize concerns about pediatric medication safety. The rising rate of opioid overdose deaths, reports of harm associated with cannabis use, and behavioral health emergencies in the pediatric population highlight these as areas for intervention. Higher levels of pediatric readiness have been associated with reductions in short- and long-term mortality rates, suggesting that improved pediatric readiness may prevent pediatric deaths. In the American Academy of Pediatrics' policy statement on pediatric readiness in the ED, adding pharmacists with pediatric competency to ED teams was recommended as a practice to improve patient and medication safety.

Conclusion: Higher levels of pediatric readiness provide an opportunity to improve outcomes for pediatric patients across the US. Medication errors, behavioral health emergencies, and substance use are some of the most pertinent issues affecting pediatric patients seeking emergency care today. By evaluating trends and recent literature within these areas, this clinical review highlights numerous opportunities to improve healthcare practices and pharmacotherapeutic care for pediatric patients.