Utilization of local surveillance data has been shown to help risk stratify patients presenting to the emergency department. We performed a retrospective cross-sectional medical record review of all adolescent visits to two large urban pediatric EDs in Washington, DC over one calendar year (n=19001). Modeling real time surveillance and other clinical information readily available in the electronic medical record may improve prediction of sexually transmitted infections in adolescents presenting to the ED, decrease empiric treatment, and allow for targeted public health prevention.