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Emergency Severity Index (ESI) Implementation Handbook, 2012 Edition

Table 6-7. Examples of Pediatric Psychiatric Patients and ESI Levels

Table 6-7. Examples of Pediatric Psychiatric Patients and ESI Levels

Patient PresentationResourcesESIRationale
17-year-old male, history of suicidality, found unresponsive by parents. There are several bottles of liquor, and unidentified empty pill bottles next to bed.Life saving intervention. No need to assess for number of resources.ESI level 1Life threatening situation—unresponsive.
16-year-old male brought in by parents who report patient was out of control, screaming obscenities, and threatening to kill the family. He is cooperative in triage and answers your questions calmly.High-risk situation. No need to assess for number of resources.ESI level 2High risk situation—danger to self and others.
15-year-old female presents to ED with her boyfriend claiming, "I think I'm pregnant. When I told my mom she threw me out of the house and told me never to come back. I have no place to live, and now I might have a baby." VS: BP 126/85, HR 100, RR 16, T 98.7°F.More than one resource.ESI level 3Will require labs, and possibly more than one specialty consult.
10-year-old female presents to the ED with mother who states that she received a call from her teacher because the child has been disrupting the class with sudden outbursts. Mom has never witnessed this behavior, but she does state that she becomes very defiant when she doesn't get her own way. Currently, the child is laughing and playing with her little sister. VS: 98/72, HR 82, RR 22, T 98.2°F.One resource.ESI level 4Will require a specialty consult.
13-year-old male walks into the ED with his mother on a Friday night. Mom states, "I didn't realize he was out of his medications for his ADHD, and I don't want him to miss a day." The patient is cooperative and pleasant. VS: BP 108/72, HR 78, RR 14, T 98.6°F.No resources.ESI level 5Will require a prescription filled.

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Current as of November 2011
Internet Citation: Emergency Severity Index (ESI) Implementation Handbook, 2012 Edition: Table 6-7. Examples of Pediatric Psychiatric Patients and ESI Levels. November 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/esi/esitab6-7.html