With increasing rates of mental health illness among children in the United States and diminishing community health resources, pediatric emergency departments (EDs) face higher volumes of patients presenting with psychiatric concerns.1,2 Many patients who require psychiatric hospitalization board in the ED despite needing treatment that extends beyond the scope of most EDs.2 While EDs are tasked with providing extended care for patients with acute mental illness, little is reported on the clinical characteristics or interventions used in managing high-risk patients awaiting placement.