Podcast 840: Abnormal Pediatric Vitals at Discharge

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Pediatric patients frequently have vital signs considered abnormal for age at discharge</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Large multicenter study recently evaluated if pediatric patients discharged with abnormal vital signs have worse outcomes</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;"> </span><span style= "font-weight: 400;">97,824 pediatric discharges were included in the study</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">18.1% were discharged with vitals considered abnormal for age</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">No significant difference in readmission rates at 48 hours (2.28% in abnormal cohort vs. 2.45% in normal cohort)</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">No significant adverse outcomes in those discharged with abnormal vital signs (4 total PICU admissions with no deaths, CPR, or intubations)</span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">When considering discharging pediatric patients, it is important to evaluate how the patient looks rather than just relying on vital signs</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">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</span></li> </ul> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Kazmierczak M, Thompson AD, DePiero AD, Selbst SM. Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs.</span> <em><span style="font-weight: 400;">Am J Emerg Me