Emergency Department Management of Eating Disorder Complications in Pediatric Patients | Digest
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Emergency Department Management of Eating Disorder Complications in Pediatric Patients

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Points & Pearls Excerpt

  • Compared with other psychiatric disorders, eating disorders are associated with the highest mortality rates. Early screening and consultation with psychiatry improves long-term care and reduces relapse.
  • Strict dieting as well as a history of childhood abuse are risk factors for developing an eating disorder. Obese children, athletes, models, and dancers are especially susceptible to developing an eating disorder.
  • Patients with eating disorders may present with common emergency department (ED) complaints such as abdominal pain, chest pain, syncope, or palpitations. These patients also have high rates of mood disorders and substance abuse. A mindful history and the SCOFF questionnaire (see Table 3) can be used to screen for eating disorders.
  • Physical examination may reveal growth stunting, lanugo, sialadenosis, dental erosion, enamel loss, calluses on the dorsal side of the hand (Russell sign), low blood pressure (< 90/60 mm Hg), and bradycardia.
  • A complete blood cell count, complete metabolic panel, magnesium, and phosphorus should be obtained for all patients with a suspected eating disorder. Additional diagnostic studies for evaluation of complications depends on presenting symptoms: chest x-ray, electrocardiogram, and telemonitoring for chest pain or bradycardia/hypotension; creatine kinase for muscular pain; and plain films or magnetic resonance imaging (MRI) for skeletal pain.

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Publication Information
Authors

Stacey Ernest, MD; Heather M. Kuntz, MD

Peer Reviewed By

Susan Fraymovich, DO; Kimberly Nordstrom, MD, JD

Publication Date

February 2, 2020

CME Expiration Date

February 2, 2023

CME Credits

4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits.

Pub Med ID: 31978295

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