Emergency Medicine | Clinical | Adolescent Health & Screening
Saint Louis Children’s Hospital’s ER sees over 500 adolescents a month, many from urban St. Louis or the surrounding areas. St. Louis has consistently been in the top 5 cities in the country for Chlamydia, Gonorrhea and Syphilis over the past several years. Given that adolescents often use the ER for primary care, our ER is piloting several projects to improve adolescent care in the ED.
Dr. Ahmad launched a computer assisted self-interview system to screen for STIs for all adolescents regardless of presenting complaints that integrates with the EMR in real-time. If a patient is screened to be at risk for an STD, it will ask the patient confidentiality if they would like to be tested. If the patient chooses the affirmative, it triggers a message to the managing physician to consider ordering testing.
Dr. Jaeger and Dr. Leonard are designing a similar screening tool to be used for mothers of infants and neonates to screen for post-partum depression. Positive screens trigger an immediate link to the social work team who will provide resources and arrange for close outpatient follow up with psychiatry.
Many ED providers have been trained by to place Nexplanon (long-acting implantable hormonal contraception) thanks to a grant from Merck obtained by Dr. Fischer as part of her fellow’s project. In addition, the ER offers Depo shots, OCP prescriptions, and condoms delivered in a nondescript envelope.
Washington University also has an outpatient walk-in clinic for teens and young adults offering free medical and social services. Goals may range from getting back in school and starting contraception, to addressing a mental illness or seeking care for HIV.