scholarly journals 531 A paediatric emergency department asthma assessment tool to identify high risk children in accordance with the national review of asthma deaths guidelines

2021 ◽  
Author(s):  
Claire Stevens ◽  
Madeleine Glasbey ◽  
Martin Smith ◽  
Kim Coxall ◽  
Katherine Eastham
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Assessment Tool ◽  
Paediatric Emergency Department ◽  
National Review ◽  
Paediatric Emergency ◽  
High Risk Children

Unscheduled re-attendances to a paediatric Emergency Department: an audit

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A9.3-A10
Author(s):  
Lisa Black
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
High Risk Patient ◽  
Primary Care Providers ◽  
Safety Net ◽  
Upper Respiratory Tract ◽  
Periodic Review ◽  
Care Providers ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency

IntroductionUnscheduled re-attendances (UR) continue to pose a problem to the Paediatric Emergency Department (PED) and there is paucity of research on this topic. 5% of PED attendances are UR.1 Although some are inevitable, it is important to identify strategies to minimise such attendances.ObjectivesTo estimate the size of the problem, identify high risk patient groups and determine other factors (system or doctor) related to UR within an inner city PED.MethodsAll patients under the age of 17, who reattended within 72 h, over a 28-day period, were identified and their Emergency Department notes reviewed.Results91 children were identified, which represented an UR rate of 3.88%, of which 69 (76%) were under 5 years old. Gastroenteritis (GE) and upper respiratory tract infection (URTI) were the predominant causes of UR. 67% of children were assessed by a junior doctor (JD {< ST2}) on initial presentation. On re-attendance, 74% were again assessed by a JD contrary to department policy and on both occasions less than half were discussed with a senior doctor. Only 70% were discharged with a documented safety net advising appropriate re-attendance. Four children had a revised diagnosis on re-attendance and 22% were ultimately admitted.ConclusionsUR is an important performance indicator and a periodic review should be a part of clinical governance activity. High risk groups for UR were <5 s, GE and URTI. We suggest that improved discharge information for parents with expected disease course, better supervision of JD / initial senior review and better collaboration with primary care providers may decrease such UR.

scholarly journals Dynamic adaptation to COVID-19 in a Singapore paediatric emergency department

2020 ◽  
pp. emermed-2020-209634
Author(s):  
Ronald Ming Ren Tan ◽  
Gene Yong-Kwang Ong ◽  
Shu-Ling Chong ◽  
Sashikumar Ganapathy ◽  
Arif Tyebally ◽  
...  
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Healthcare Personnel ◽  
Short Report ◽  
Intermediate Risk ◽  
Public Health Response ◽  
Resuscitation Room ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Isolation Facility

Singapore was one of the earliest countries affected by the coronavirus disease 2019 (COVID-19) pandemic, with more laboratory-confirmed COVID-19 cases in early February 2020 than any other country outside China. This short report is a narrative review of our tertiary paediatric emergency department (ED) perspective and experience managing the evolving outbreak situation. Logistic considerations included the segregation of the ED into physically separate high-risk, intermediate-risk and low-risk areas, with risk-adapted use of personal protective equipment (PPE) for healthcare personnel in each ED area. Workflow considerations included the progressive introduction of outpatient COVID-19 testing in the ED for enhanced surveillance; adapting the admissions process particularly for high-risk and intermediate-risk cases; and the management of unwell accompanying adult caregivers. Manpower considerations included the reorganisation of medical manpower into modular teams to mitigate the risk of hospital transmission of COVID-19. Future plans for a tiered isolation facility should include structural modifications for the permanent isolation facility such as anterooms for PPE donning/doffing; replication of key ED functions in the tent facility such as a separate resuscitation room and portable X-ray room; and refresher PPE training. Dynamic reassessment of ED workflow processes, in conjunction with the hospital and national public health response, may help in managing this novel disease entity.

scholarly journals 72 Validating MyHEARTSMAP, an emergency psychosocial self-assessment and management tool, among youth with minor traumatic brain injuries or minor orthopaedic injuries seen in the Paediatric Emergency Department

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e30-e30
Author(s):  
Erik Lamoureux ◽  
Takuro Ishikawa ◽  
Keith Yeates ◽  
Miriam Beauchamp ◽  
William Craig ◽  
...  
Keyword(s):  
Emergency Department ◽  
Convergent Validity ◽  
Assessment Tool ◽  
Social Issues ◽  
Pearson Correlation ◽  
Assessment Tools ◽  
Management Tool ◽  
Self Assessment ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency

Abstract Background Fewer than 20% of the estimated 1.2 million Canadian youths living with mental health (MH) concerns receive adequate care. Paediatric emergency department (PED) visits related to MH are increasing across North America. The online self-assessment tool, MyHEARTSMAP, was developed to facilitate screening of MH concerns in the PED and general practice. MyHEARTSMAP assesses 10 psychosocial areas, mapping to four domains of MH (Psychiatry, Function, Social, and Youth Health) to provide domain-specific recommendations for patient management (Figure A). Objectives We evaluated the convergent validity of MyHEARTSMAP when compared to established psychosocial self-assessment tools: Paediatric Quality of Life (PedsQL) and Strengths and Difficulties Questionnaire (SDQ). Design/Methods We conducted a cross-sectional study among youths and parents enrolled in a larger cohort study: Advancing Concussion Assessment in Paediatrics (A-CAP). Participants were children aged 8 to 16 years old with mild traumatic brain injury or orthopaedic injury and their parents. Participants were recruited from two PEDs in Alberta and British Columbia and were asked to complete MyHEARTSMAP, in addition to the PedsQL and SDQ completed in their A-CAP study procedures. We evaluated three MH domains from MyHEARTSMAP (PSYCHIATRY FUNCTION, AND SOCIAL) to their corresponding score sections in PedsQL (EMOTIONAL, SCHOOL, and SOCIAL) and SDQ (EMOTIONAL, none, and CONDUCT and PEER). We calculated Pearson correlation coefficients between these corresponding domains and sections. Results We recruited 40 child and parent pairs from Alberta and 82 from BC. The children were on average aged 12.6 years old (SD 2.2) and 44% were female. The tools screened participants as “at-risk” for various MH concerns at a rate of 26.7% to 60.8% for MyHEARTSMAP, 2.5% to 13.9% for PedsQL, and 12.3% to 16.0% for SDQ. Overall, MyHEARTSMAP was moderately correlated with PedsQL (mean ±95% CI: r = 0.405±0.151) and SDQ (mean ±95% CI: r = 0.322±0.162). Correlations (±95% CI) by MyHEARTSMAP domain for the child and parent versions, respectively, were as follows: PSYCHIATRY PedsQL (r = 0.483±0.140 / 0.509±0.134) and SDQ (r = 0.417±0.150 / 0.598±0.116); FUNCTION PedsQL (r = 0.578±0.122 / 0.455±0.143); SOCIAL PedsQL (r = 0.249±0.170 / 0.158±0.175) and SDQ (r = 0.207±0.172 / 0.067±0.178). Conclusion In conclusion, MyHEARTSMAP PSYCHIATRY and FUNCTION domains have moderate convergent validity to PedsQL and SDQ. Unlike PedsQL and SDQ, the evaluation of social issues in MyHEARTSMAP is MH-specific, resulting in low convergent validity for the SOCIAL domain.

scholarly journals Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

2021 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Older Children ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

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