• Pediatric emergency care · Aug 2022

    Prevalence of Adverse Childhood Experiences in a Pediatric Emergency Department: Support for Trauma-Informed Pediatric Emergency Care.

    • Elise Alves Graber, Amy Puchalski, Christyn Magill, and Stacy Reynolds.
    • From the Department of Emergency Medicine, Atrium Health's Carolinas Medical Center, Charlotte, NC.
    • Pediatr Emerg Care. 2022 Aug 1; 38 (8): 372375372-375.

    ObjectivesData from the 2019 National Survey of Children's Health revealed that 39.8% of children in the United States have been exposed to adverse childhood experiences (ACEs), which are risk factors for long-term negative health outcomes. This study aimed to determine the prevalence of ACE exposure in a pediatric emergency department (ED) patients and describe the association between ACE exposure and ED recidivism.MethodsFive hundred children aged 0 to 17 years were evaluated for ACE exposure in an academic, urban, tertiary-care, pediatric ED via convenience sampling. The 2019 National Survey of Children's Health section on ACEs was administered to define ACE exposure. A prospective chart review was conducted on all children enrolled in the study to collect data on ED utilization for 1-year postsurvey. The relationship between ACE exposure and ED recidivism was examined by calculating relative risk.ResultsWe found that 40.2% (confidence interval [CI], 36.5%-45.3%) of respondents had ACE exposure. The most frequently reported ACEs were poverty (20.8%; CI, 17.3%-24.6%), divorce/separation (18.2%; CI, 14.9%-21.9%), and mental illness within the household (7.2%; CI, 5.1%-9.8%). Adverse childhood experience exposure in this pediatric ED was similar to the national prevalence. There was no significant relationship between ACE exposure and high ED recidivism as an adverse outcome.ConclusionsAdverse childhood experience exposure in this population matched the prevalence reported in the national population. Our results suggest that this group is particularly important when mitigating these risk factors for long-term adverse health outcomes. Adverse childhood experience exposure did not appear to impact recidivism in a period of unprecedented low ED volumes during the coronavirus disease pandemic.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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