• Sarah D Becker, Ellis Rochelson, Michael Lienhard, David Silber, Wenzhu B Mowrey, and Lisa Hutchison.
• From the Division of Child and Adolescent Psychiatry, Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell at Zucker Hillside Hospital, Glen Oaks, NY.
• Pediatr Emerg Care. 2022 Jan 1; 38 (1): e393e397e393-e397.

ObjectivesChildren presenting to the emergency department (ED) requiring psychiatric admission often undergo screening electrocardiograms (ECG) as part of the medical clearance process. The diagnostic yield of screening ECGs for this purpose has not been reported. The purpose of this study was to determine the clinical utility of screening ECGs in children and adolescents requiring acute inpatient psychiatric admission.MethodsA single-center retrospective study of patients aged 5 to 18 years who did not have documented indications for ECG and underwent screening ECG before psychiatric inpatient admission over a 2-year period was conducted. Abnormal ECGs were identified via chart review and were reinterpreted by a pediatric cardiologist to determine potential significance to psychiatric care. Impact on treatment and disposition was examined.ResultsFrom January 2018 through December 2019, 252 eligible pediatric patients had a screening ECG in the ED before psychiatric admission. Twenty-one (8.3%) of these ECGs were interpreted as abnormal, and 6 (2.4%) were determined to be potentially relevant to psychiatric care in the setting of specific medication use. The abnormal ECG interpretations resulted in additional workup and/or cardiology consultation for 7 (2.7%) patients but had no impact on psychiatric admission.ConclusionsIn the absence of concerning individual or family history or cardiac symptoms, routine screening ECGs as part of medical clearance for psychiatric admission are not warranted given the low yield of meaningful findings. The decision to obtain an ECG should be made with careful consideration of medical history and in the presence of specific indications.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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