Use of emergency services by unaccompanied minors

STUDY OBJECTIVE: The objective of the study was to describe the use of emergency services by minors who are unaccompanied by their parents or guardians and how they are managed in emergency departments. DESIGN: Self-administered survey. TYPE OF PARTICIPANTS: The ED directors of 71 emergency medicine training programs, 82 Michigan community EDs, and 56 pediatric EDs. MEASUREMENTS AND MAIN RESULTS: One hundred eighteen (58%) surveys were returned. A median of five unaccompanied minors (range 0.2 to 150) were seen weekly by responding EDs. Pediatric EDs saw the most unaccompanied minors weekly (ten) compared with training programs (five) and community EDs (three) (P less than .01). Emergency medicine training programs had the greatest percentage (3.0%) of minors who were unaccompanied compared with pediatric EDs (2.2%) and community EDs (2.6%) (P less than .05). For all conditions surveyed, only 3.8% of patients would be refused medical care without parental consent. However, 36.8% of patients would have medical care delayed even for conditions that might be painful or harmful if left untreated for some time. Most EDs (85.5%) screen patients and treat those who are acutely ill, but some (11.1%) treat all regardless of severity. CONCLUSION: Protocols should be developed for unaccompanied minors to ensure that delays in obtaining consent do not jeopardize the child and that the rights of minors for confidentiality and consent are recognized.