Adolescent boys twice as likely to attend A&E

Twice as many boys as girls seek emergency healthcare, a study of adolescents attending the accident and emergency department…

Twice as many boys as girls seek emergency healthcare, a study of adolescents attending the accident and emergency department of a Dublin teaching hospital has found. And most of the 14-17 year olds who came to the emergency department did so because of acute injury.

Researchers from St Vincent's Hospital, Dublin and the School of Public Health and Population Science at University College Dublin (UCD) looked at the characteristics of the 323 adolescents who presented to the hospital's emergency department between January and March 2005.

They found that 63 per cent had an acute injury, such as a head or limb injury, while 30 per cent of adolescents had an acute illness such as abdominal pain or infection.

Some 5 per cent of 14-17 year olds were categorised as having a psycho-social problem, including those who were drunk or had taken illicit drugs.

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The study, published in the current issue of the Irish Medical Journal, also found that, while most young people came to the emergency department between 9am and 9pm, 73 per cent of night and early morning attendances were at weekends (Thursday to Sunday).

Following initial assessment, one in 10 adolescents were admitted to the hospital.

Some 35 per cent were sent home with no follow-up required, while 18 per cent of those studied were referred to their GP for further management. And 12 per cent of the 14-17 year olds were referred to the hospital's out-patient department for assessment.

Three-quarters of those categorised as having a psycho-social problem were female, while this group was also more likely to present at night and to have a prolonged stay in the emergency department.

In a follow-up study, a further 33 adolescents who attended the emergency department of St Vincent's were interviewed about their experience. Of note, four young people (12 per cent) had to be excluded from the survey because they were intoxicated due to alcohol or drugs.

While a majority of 14-17 year olds rated the care they received as either excellent or good, 46 per cent of those surveyed said there had been a delay in receiving treatment.

Many surveyed expressed a desire for greater privacy in the form of a separate adolescent area or their own treatment room.

"Our results suggest that simple measures such as increasing privacy, assigning female doctors to female patients, allowing the use of mobile phones, providing regular updates (on treatment) and entertainment such as television, radio and electronic games may improve satisfaction levels [ for adolescents]," UCD medical student Rebecca Fry and her co authors wrote.

Commenting on the results, Dr John Ryan, consultant in emergency medicine at St Vincent's Hospital, told The Irish Times: "We would like to have a dedicated area for adolescents. We are working towards having the right environment, the right level of privacy and the right level of public health advice for young people."

Particular health issues emerge during adolescence, including sexual health, teenage pregnancy, eating disorders and substance abuse.

Mental health issues such as suicide and deliberate self-harm are relatively common in this age group.