Background The “tween” ages of 9-12 years are sometimes called the “forgotten” years of pediatrics between childhood (with frequent well-child checks) and adolescence (with different risk taking behavior). Each of these age groups tends to have specific issues that arise as part of growing and developing. Much has been written about infants health care and studies have documented adolescents use of emergency departments (EDs) but little has been written on the tween age group.
Methods Our ED computerized surveillance system was searched for ED visits in 2003 for children between the ages of 9 and 12 years. Reasons for visit were documented. Data were entered into Excel and Access computer programs.
Results In 2003, there were 9801 children between the ages of 9-12 years seen in our ED. 2872 (29%) of these were for injuries, 24% for pain-related complaints; 11% respiratory symptoms; 8% fever; 3% dermatologic complaints; 2% psychiatric issues; 1.4% eye-related complaints, with the remainder being a variety of complaints. Injuries: Of the 2872 injuries there were 1145 extremity injuries (40%), 552 lacerations (19%), 227 head injuries (8%), 193 motor vehicle related (7%), and 60 falls (2%). Pain: For the chief complaint of pain, there were 636 abdominal pain, 479 throat pain, 342 headache, 256 chest pain. and 238 ear pain. Overall: 11% of the complaints were related to the abdomen (pain, trauma, etc) and overall 8% were related to fever. The psychiatric symptoms consisted of 81 cases of agitation and violent behavior, 36 overdoses, 26 suicidal ideation, 22 psychosis, 13 depression, 8 hyperventilation, and 7 anxiety attacks.
Conclusion Injuries are a major cause of ED visits in the tween age group. Other frequent complaints resulting in ED visits include pain, respiratory symptoms, and fever. Significant psychiatric issues are seen in this group. Injury prevention efforts focusing on 9-12 year olds are needed. EDs must be prepared to address psychiatric issues in this age group.