Pediatric Behavioral Health Video and Podcast Series

These introductory videos by Maureen Curtis-Cooper are a general introduction to pediatric behavioral health conditions. The first video reviews school age children with behavioral health conditions and the second video reviews the adolescent age group. For each group and condition, Maureen provides a general overview, epidemiology, and review of approach and treatment.

Maureen Curtis-Cooper is a pediatric emergency nurse educator at Boston Medical Center, serving on the board for the Massachusetts Pediatric Emergency Nurses Association (ENA) as well as serving on the national committee for course development for pediatric emergency nursing. She developed the introduction series below.

Video 1 Index: School Age Behavioral Health

0:00 to 10:30: General overview

This includes a general overview of the behavioral health population in pediatrics including the general population numbers, length of stay, diagnosis typical seen/presentations and impact of COVID.

10:30 to 2330: General approach

The general approach to the pediatric patient with a behavioral health condition. Discussion around general securing the room, principles of ED care, establishing a relationship, managing anxiety regarding their visit

22:30-23:00: Brief Overview of Medications for Agitation

Brief focused comments on recommendation of medication for agitation in the school age population

23:00-35:00: Development and common diagnoses in School Age population

Common behavioral health diagnosis in the school age population (5-12yo) with a review of normal growth/development in the school age population leading to general approach to the population: activities for them and their family. This section also includes specific common diagnosis and medications typically used

Video 2 Index: Adolescent Behavioral Health Population:

0:00-8:30: General overview and approach

Scope of the adolescent behavioral health patient. Includes common growth and development, general approach to adolescents in the ED.

8:30-33:00

Discussion of common diagnosis in this patient population (Depression, Anxiety, oppositional defiant, conduct, bipolar disorders) and approaches to care in the ED.

33:00-41:17

Suicide in the adolescent population including screening and risk factors.

This video by Jen Schlesbusch focuses directly on pediatric patients within the emergency department presenting with a behavioral health crisis. Using this video (or portions of it) will aide in your discussions with the patient, safety while in your emergency department, and recommendations if they have become escalated.

Jen Schlesbusch is a member of the behavioral responses team in the emergency department at Boston Children's Hospital as a mileu counselor. She has worked at BCH for the last 15 years with experience with patients requiring inpatient psychiatric care but transitioned to the behavioral response team 7 years ago. She is also a Reiki practitioner focusing on meditation, coping skills, and breathing techniques bringing this knowledge to the hospital setting.

Video 3 Index:
0:00-0230 Introduction

Introduction to the speaker Jen Schlebusch and topic concept.

0300-0705

ABCs of behavior management. Understanding and responding effectively to problematic behavior. A: Antecedent, B: Behaviors and C: Consequences. This portion also goes through strategies to identify and define the behaviors of a patient.

0705-0940 Safety Issues

Review of specific issues with safety of patients, suggestions for increased safety for patients and healthcare workers. Consideration of type of monitoring type, room sweeps.

0940-1530

Considerations of triggering items for behavioral health patients with recommendation of decreasing these triggers which can help prevent escalations.

1530-2045

Non-medication strategies to decrease agitation while in the ED.

2045-2910

Consequences when behavioral is undesirable do’s and don’ts.

2910-3950

Language and communication recommendations for patients which can aide in interactions and behaviors.

This video by Dr. Qayyum will help in recommendation for initiation of pharmacological management medications while a pediatric patient is in behavioral crisis. This includes a discussion of the types of medications, case representations as well as recommendations for a pediatric patient with agitation or aggression.

Zheala Qayyum, MD, MMSc is the medical director of emergency psychiatric service at Boston Children's Hospital as well as the director of the adolescent psychology fellowship. She is faculty as Yale School of Medicine as well as Harvard Medical School.

Video 4 Index:

0000-0430

Introduction to the speaker as well as the topic with a focus on the increase in visits for behavioral health patients to the emergency department leading to increased initiation of medications while awaiting inpatient psychiatric care.

0430-0740

Starting points when considering interventions acutely in the emergency setting for behavioral health patients.

0740-840

Non-pharmacologic management including clear communication, calming strategies and more.

840-1120

Consideration for initial work up if consideration of starting medication or changing during their emergency department stay. Recommendations for medications that may need levels.

1120-1525

Case review of a patient presenting with psychotic symptoms. Including differential, considerations, medications commonly used.

1525-1830

Case review of patient presenting with manic symptoms. Including differential, considerations, medications commonly used.

1830-2110

Case review of patient presenting with anxious symptoms. Including differential, considerations, medications commonly used.

2110-2200

Major Depressive disorder initial medication recommendations.

2200-3130

Recommendation for medication to help with agitation while in the ED. Detailed description of medication use, dosage and side-effects for agitation.

3130-3358

Focused tips on medication use—what not to use together for example

From establishing rapport and re-learning our introductions to gender-neutral physical exams and countering prior health care discrimination, this 3-part podcast series discusses how to affirm and care for LGBTQ+ youth in the Emergency Department. Join hosts Tom Balga (he/him) and Michael Goldman (he/him) with special guests Dax Sousa (he/him) and Kristen Campbell (she/they) as they discuss how we can do better for ALL our patients.

Part 1 Title : "A More Inclusive Introduction: Establishing Rapport with your LGBTQ+ Patients" (30 minutes)

https://soundcloud.com/yaleuniversity/a-more-inclusive-introduction-establishing-rapport-with-your-lgbtq-patients

Part 2: “The mental health burden of our LGBTQ+ patients Part 1” (15 minutes)

https://soundcloud.com/yaleuniversity/the-mental-health-burden-of-our-lgbtq-patients-part-1

Part 3: “The mental health burden of our LGBTQ+ patients Part 2” (16 minutes)

https://soundcloud.com/yaleuniversity/the-mental-health-burden-of-our-lgbtq-patients-part-2

Draft of Video Introduction Email to ED Staff