Similarly, another 2017 retrospective article looked at 126,774 children younger than 19 years of age discharged from two pediatric EDs and four urgent care centers.¹⁰ Discharge

tachycardia was defined as greater than or equal to 99 percent for age and was found in 10,470 (8.3 percent) of the patients. Compared to patients who did not have discharge tachycardia, children with discharge tachycardia had an increased risk of revisit within 72 hours of discharge (adjusted RR 1.3; 95 percent CI 1.2-1.5). Although there was an increased risk of bouncing back within 72 hours, children with discharge tachycardia were not associated with clinically important interventions when they returned (RR 1.0; 95 percent CI 0.9-1.0). Clinically important interventions were defined as supplemental oxygen, respiratory medications and admission, antibiotics and admission, and peripheral IV line placement and admission. One child in the cohort bounced back and required CPR, but this child did not have tachycardia at discharge. Again, this study emphasizes the importance of discharge education and instruction.

Pediatric tachycardia can be due to fever or other occult diagnoses, or it may predict an increased risk of return to the ED.

Dr. Jones is assistant professor of pediatric emergency medicine at the University of Kentucky in Lexington.

Dr. Cantor is professor of emergency medicine and pediatrics, director of the pediatric emergency department, and medical director of the Central New York Regional Poison Control Center at Upstate Medical University in Syracuse, New York.

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