High-risk Pediatric Emergencies

Emerg Med Clin North Am. 2020 May;38(2):383-400. doi: 10.1016/j.emc.2020.01.004.


More than half of pediatric malpractice cases arise from emergency departments, primarily due to missed or delayed diagnoses. All providers who take care of children in emergency departments should be aware of this risk and the most common diagnoses associated with medicolegal liability. This article focuses on diagnosis and management of high-risk diagnoses in pediatric patients presenting to emergency departments, including meningitis, pneumonia, appendicitis, testicular torsion, and fracture. It highlights challenges and pitfalls that may increase risk of liability. It concludes with a discussion on recognition and management of abuse in children, including when to report and decisions on disposition.

Keywords: Medical error; Medicolegal; Pediatric emergency malpractice; Pediatric emergency medicine; Risk management.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Appendicitis / diagnosis
  • Appendicitis / therapy
  • Child
  • Child Abuse / diagnosis
  • Child Abuse / therapy
  • Child, Preschool
  • Emergencies*
  • Emergency Medicine / legislation & jurisprudence
  • Emergency Medicine / methods
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Malpractice*
  • Meningitis / diagnosis
  • Meningitis / therapy
  • Pneumonia / diagnosis
  • Pneumonia / therapy
  • Risk Management*
  • Spermatic Cord Torsion / diagnosis
  • Spermatic Cord Torsion / therapy
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / therapy