Emergency Medical Minute29 Dec 2022

Podcast 840: Abnormal Pediatric Vitals at Discharge

Contributor: Aaron Lessen, MD

Educational Pearls:

Pediatric patients frequently have vital signs considered abnormal for age at discharge
Large multicenter study recently evaluated if pediatric patients discharged with abnormal vital signs have worse outcomes

97,824 pediatric discharges were included in the study
18.1% were discharged with vitals considered abnormal for age
No significant difference in readmission rates at 48 hours (2.28% in abnormal cohort vs. 2.45% in normal cohort)
No significant adverse outcomes in those discharged with abnormal vital signs (4 total PICU admissions with no deaths, CPR, or intubations)

When considering discharging pediatric patients, it is important to evaluate how the patient looks rather than just relying on vital signs

Consider leaving the child attached to a monitor, leaving the room, and then reevaluating them if they could be agitated by the presence of healthcare providers

References

Kazmierczak M, Thompson AD, DePiero AD, Selbst SM. Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs. Am J Emerg Med. Jul 2022;57:76-80. doi:10.1016/j.ajem.202

Image from:

Vital Signs. MedlinePlus. https://medlineplus.gov/vitalsigns.html. Accessed December 29, 2022.

Summarized by Mark O'Brien, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD

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