Adolescent Mischief

24 August, 2011 by: colinparker

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It’s a tough transition, from childhood to adulthood… some of us are still trying to grow up. Looking after teenagers in a medical context can be tricky too – how can you be cool, without looking like a fool?

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In this episode we discuss the challenges of establishing trust, and making a thorough and balanced assessment in a busy, noisy Emergency Department. The HEADSS assessment tool is a great way to start the ball rolling…¬†Check out Colin’s pseudo-British accent in the role-play!


Outline: Adolescent Mischief PEMcast

[cp] Introduction, disclaimer

[kb] Definition of adolescence
Cutoff age =16 at our hospital, 18 in US, Adolescent medicine considered by some to be up to 25 yrs age

[rr] Challenges of being a teenager
ie changing body, societal role, expectations, impending career, friends / bullying (including cyber-bullying), belief system, family

[cp] Challenges of caring for teenagers
ie autonomy, risk-taking behaviour, privacy issues vs parents, communication, attitude, limited experience & intellectual capacity

[kb] [rr] Presentations to ED:
Usual medical/surgical conditions +/- modified presentation (eg torsion & shyness, compliance with chronic conditions eg diabetes, asthma)
Mental health / behavioural / self-harm
Sexual health issues
The case for Adolescent Medicine as a subspecialty
eg transition to Adult services for chronic conditions

[rr] UK‘s RCPCH Adolescent Health Programme

[all] HEADSS:
H: Home environment
E: Education & Employment
(E: Eating)
A: peer-related Activities
D: Drugs
S: Sexuality
S: Suicide/depression
(S: Safety from injury & violence)

Opening lines, good and bad (refer to Table 2 in Goldenring & Rosen 2004 paper):
-exploring ways of communicating with young people.

[all] Goodbye, catch you next time!

References

Getting into Adolescent Heads: an essential update
John Goldenring & David Rosen
Contemporary Pediatrics, Jan 1,  2004
http://www.aap.org/pubserv/psvpreview/pages/Files/HEADSS.pdf

Goldenring JM, Cohen E: Getting into adolescent heads.
Contemporary Pediatrics 1988;5(7):75

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