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Engaging with and assessing the adolescent patientMental state examination
EDs are potentially life-threatening conditions - Anorexia Nervosa has the highest mortality of any psychiatric disorder.
Early intervention is the best way to assist with successful recovery. It is important to recognise warning signs and refer to the appropriate service.
Red flag features in
Consider medical admission for those with:
Feeding should only commence after blood results have been reviewed and the patient has been discussed with admitting team.
The agreed feeding plan should be commenced as soon as possible and ideally in the emergency department.
There is a risk of refeeding syndrome, potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients being refed. The hallmark biochemical feature of refeeding syndrome is hypophosphataemia.
Consider cardiac monitoring after discussion with the admitting consultant for:
If medically stable but concerns about mental health (e.g. suicidal, comorbid psychiatric disorder or out of control ED compensatory behaviours), discuss with local mental health team.
CAYP are medically unstable (as above) or requiring admission.
To discuss appropriate follow up of CAYP being discharged from emergency.
Managing CAYP with EDs, especially those requiring refeeding or those who are medically or mentally unstable (as above).
Eating Disorders Clinical Nurse consultants 9345 6533
Adolescent Medicine Consultant on call 9345 5522 page via switchboard
Eating Disorder Clinical Nurse Consultant in business hours 9594 4642
Adolescent Med Consultant on call 9594 6666 via switchboard
For medically unstable patients who require escalation of care beyond capacity/comfort of the local team/facility
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Last updated August, 2017