Intentional paediatric poisoning presentations to emergency departments during the COVID-19 pandemic

Objective: To characterise paediatric poisoning presentations to EDs and determine if the advent of the COVID-19 pandemic was associated with increased intentional paediatric poisoning presentations. Methods: We performed a retrospective analysis of paediatric poisoning presentations to three EDs (two regional and one metropolitan). Simple and multiple logistic regression analysis were performed to determine the association between COVID-19 and intentional poisoning events. In addition, we calculated the frequency with which patients reported various psychosocial risk factors as being an implicating factor in engaging in an intentional poisoning event. Results: A total of 860 poisoning events met inclusion criteria during the study period (January 2018–October 2021), with 501 being intentional, and 359 unintentional. There was an increased proportion of intentional poisoning presentations during the COVID-19 pandemic (261 intentional and 218 unintentional in the pre-COVID-19 period vs 241 intentional and 140 unintentional during the COVID-19 period). In addition, we found a statistically significant association between intentional poisoning presentations and an initial COVID-19 lockdown (adjusted odds ratio 26.32, P < 0.05). ‘The COVID-19 lockdown’ or ‘COVID-19’ was reported to be implicating factor for psychological stress in patients who presented with intentional poisonings during the COVID-19 pandemic. Conclusions: Intentional paediatric poisoning presentations increased during the COVID-19 pandemic in our study population. These results may support an emerging body of evidence that the psychological strain of COVID-19 disproportionately impacts adolescent females. © 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine

Characteristics of non-urgent neonatal presentations to an Australian metropolitan emergency department

Aim To determine characteristics and risk factors for non-urgent presentations (NUPs) (triage categories 4 and 5) in neonates to a Western Sydney metropolitan mixed adult emergency department (ED) and the effect of COVID-19 on presentations and admissions. Methods A retrospective medical record study examined neonates (age \u3c4 weeks) presenting to the ED between October 2019 and September 2020 and assessed risk factors for NUPs including the impact of COVID-19. Regression analysis was used to determine which risk factors were significant for NUPs to ED and whether there were any significant differences in urgency of presentations and admissions during the post-COVID-19 time (on/after 11th March 2020). Results From 277 presentations, 114 (41%) were non-urgent. After regression analysis, being a mother born overseas (odds ratio 2.15, 95% confidence interval 1.13–4.12, P = 0.02) was a significant risk factor and maternal age (odds ratio 0.98, 95% confidence interval 0.96–0.1.00, P = 0.02) was a significant protective factor for NUPs in the neonatal period. There were 54 (47%) NUPs pre-COVID-19 and 60 (53%) NUPs post-COVID (P = 0.70). There were similar presenting complaints and diagnoses compared to the literature. Conclusions Mothers born overseas and younger maternal age were found to be significant risk factors for NUPs in the neonatal period. There was no apparent impact on presentations and admissions to ED during the COVID-19 period. Further studies are warranted to further evaluate risk factors for NUPs in the neonatal period and further elucidate the impact of COVID-19 on presentations and admissions, specifically in later waves of the virus

Intentional paediatric poisoning presentations to emergency departments during the COVID-19 pandemic

Objective: To characterise paediatric poisoning presentations to EDs and determine if the advent of the COVID-19 pandemic was associated with increased intentional paediatric poisoning presentations. Methods: We performed a retrospective analysis of paediatric poisoning presentations to three EDs (two regional and one metropolitan). Simple and multiple logistic regression analysis were performed to determine the association between COVID-19 and intentional poisoning events. In addition, we calculated the frequency with which patients reported various psychosocial risk factors as being an implicating factor in engaging in an intentional poisoning event. Results: A total of 860 poisoning events met inclusion criteria during the study period (January 2018–October 2021), with 501 being intentional, and 359 unintentional. There was an increased proportion of intentional poisoning presentations during the COVID-19 pandemic (261 intentional and 218 unintentional in the pre-COVID-19 period vs 241 intentional and 140 unintentional during the COVID-19 period). In addition, we found a statistically significant association between intentional poisoning presentations and an initial COVID-19 lockdown (adjusted odds ratio 26.32, P \u3c 0.05). ‘The COVID-19 lockdown’ or ‘COVID-19’ was reported to be implicating factor for psychological stress in patients who presented with intentional poisonings during the COVID-19 pandemic. Conclusions: Intentional paediatric poisoning presentations increased during the COVID-19 pandemic in our study population. These results may support an emerging body of evidence that the psychological strain of COVID-19 disproportionately impacts adolescent females