scholarly journals Characteristics of low-acuity paediatric emergency department consultations in two tertiary hospitals in Switzerland: a retrospective observational study

2021 ◽  
Vol 5 (1) ◽  
pp. e001267
Author(s):  
Manon Jaboyedoff ◽  
Carl Starvaggi ◽  
Joan-Carles Suris ◽  
Claudia E Kuehni ◽  
Mario Gehri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Healthcare System ◽  
Tertiary Care ◽  
Urgent Care ◽  
Retrospective Observational Study ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Care Services ◽  
French Speaking

BackgroundLow-acuity paediatric emergency department (PED) visits are common in high-income countries and are an increasing burden for the healthcare system and quality of care. Little is known about low-acuity PED visits in Switzerland. This study shows frequency and characteristics of such visits in two large PEDs in German-speaking and French-speaking regions of Switzerland.MethodsWe conducted a retrospective observational study in the PED of two Swiss tertiary care hospitals, Bern and Lausanne. We extracted standardised administrative and medical data from the clinic information system for all PED visits of children aged 0–17 years from January to December 2018. We defined low-acuity visits as those meeting all of the following criteria: (1) triage category 4 or 5 on the Australasian Triage Scale, (2) no imaging or laboratory test performed and (3) discharge home. We used a binary multiple logistic regression model to identify factors associated with low-acuity visits.ResultsWe analysed 53 089 PED visits. The proportion of low-acuity visits was 54% (95% CI 53% to 54%, 28 556 visits). Low-acuity visits were associated with age younger than 5 years (adjusted OR, aOR 1.87, 95% CI 1.81 to 1.94), living within a 5 km radius of PED (aOR 1.27, 95% CI 1.22 to 1.32), and after hour presentations (weekends: aOR 1.14, 95% CI 1.10 to 1.18, nights: aOR 1.10, 95% CI 1.23 to 1.36).ConclusionLow-acuity visits are frequent in our PEDs and associated with younger age and convenience factors (proximity of residency and after hour presentation), pointing to a high demand for paediatric urgent care services in Switzerland not currently covered by the primary healthcare system.

scholarly journals Why did the children stop coming? Reasons for paediatric emergency department attendance decrease during the first wave of the COVID-19 pandemic in the United Kingdom: A qualitative study

2021 ◽  
Author(s):  
Matthew Breckons ◽  
Sophie Thorne ◽  
Rebecca Walsh ◽  
Sunil Bhopal ◽  
Stephen Owens ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
United Kingdom ◽  
Substantial Reduction ◽  
Healthcare Services ◽  
Urgent Care ◽  
List Type ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Health Messaging

AbstractObjectiveTo explore parent’s experiences and views relating to their use of children’s emergency healthcare services during the Covid-19 pandemic.DesignQualitative telephone interview study using in-depth interviews, based on the principles of grounded theory. Recorded, transcribed verbatim, managed in NVivo version 12, analysed by thematic analysis.SettingNorth East England, United Kingdom.ParticipantsParents of children aged 0-8 years.FindingsThree major themes emerged from the interview data: Risk to children and families, Sources of Information, and Making Healthcare-seeking Decisions. These themes encompassed a range of intellectual and emotional responses in the way that parents interpreted information related to Covid-19, and their sense of responsibility towards family and wider society.ConclusionsTogether these themes aid understanding of the changes in paediatric emergency department attendances reported in the early months of the Covid-19 pandemic in the UK. The analysis suggests that public health messaging directed at those seeking urgent care for children may be inadequate and lead to adverse consequences, the impacts of which require further study and refinement.What is known about the subjectFollowing lockdown, there was a substantial reduction in the number of children taken to unscheduled medical care across the countryDelays in presentation can impact on children’s healthIt is not known what parents’ views are on accessing emergency health services in a pandemic situationWhat this study addsParents had to weigh up a number of information sources before deciding on whether to take their child to hospitalPublic health messaging directed at those seeking urgent care for children may lead to a reduction in use of emergency healthcare servicesFuture lockdowns should implement focussed strategies, optimising use of emergency healthcare services, whilst avoiding harm.

Understanding the use of emergency department and urgent care services by diabetic patients of a Family Medicine Health Team: a retrospective observational study

2016 ◽  
Vol 18 (02) ◽  
pp. 200-207 ◽  
Author(s):  
Matthew Ward
Keyword(s):  
Emergency Department ◽  
Family Medicine ◽  
Observational Study ◽  
International Classification Of Diseases ◽  
Urgent Care ◽  
Retrospective Observational Study ◽  
Diabetic Patients ◽  
Health Team ◽  
Scale Scores ◽  
Classification Of Diseases

Aim To understand the frequency, urgency, and rationale of emergency department and urgent care (ED/UC) use by diabetic patients of a Family Medicine Health Team (FHT). Methods A retrospective, observational study with comparison control groups was conducted from 1 January 2013 to 31 December 2014. A total of 693 diabetic patients were compared with two, age-standardized non-diabetic groups: one with a higher disease burden based on International Classification of Diseases 9 diagnoses and the other from a randomized patient pool. Findings The diabetic group utilized ED/UC services 1.25 and 1.92 times more often than the two control populations, consistent with that observed in other studies. Canadian Triage and Acuity Scale scores were essentially the same for the diabetic population. Only 3.1% of visits were for diabetic related emergencies, in contrast to the expected 23% by surveyed physicians of the FHT. Diabetic patient’s sought treatment for cellulitis, wounds, abscesses, and infections more often than the control populations.

scholarly journals Prospective observational study on the incidence of medication errors during simulated resuscitation in a paediatric emergency department

BMJ ◽  
2004 ◽  
Vol 329 (7478) ◽  
pp. 1321 ◽  
Author(s):  
Eran Kozer ◽  
Winnie Seto ◽  
Zulfikaral Verjee ◽  
Chris Parshuram ◽  
Sohail Khattak ◽  
...  
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Medication Errors ◽  
Prospective Observational Study ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency

Feasibility and usefulness of rapid 2-channel-EEG-monitoring (point-of-care EEG) for acute CNS disorders in the paediatric emergency department: an observational study

2020 ◽  
pp. emermed-2020-209891
Author(s):  
Leopold Simma ◽  
Florian Bauder ◽  
Thomas Schmitt-Mechelke
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Point Of Care ◽  
Convulsive Status Epilepticus ◽  
Monitoring Point ◽  
Cns Disorders ◽  
Targeted Interventions ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Acute Seizures

IntroductionThe aim of this study was to determine the feasibility and clinical utility of point-of-care electroencephalogram (pocEEG) in the paediatric emergency department (ED) for children presenting with acute non-traumatic central nervous system (CNS) disorders.MethodsRetrospective observational study of prospectively collected data in paediatric patients (0–16 years) with acute non-traumatic CNS-disorders presenting between April 2014 and February 2017 to a single paediatric ED in Switzerland.The 2-channel EEG was applied to all patients presenting with acute seizures or impaired consciousness to the ED. For a pocEEG, scalp surface electrodes are applied in five locations, thus allowing registration of fronto-temporal bilateral cortical activity. Neurology consultants assisted with interpretation of readings. EEG findings and clinical characteristics were collected. Feasibility and usefulness were rated via Likert scale.Results36 patients with acute seizures or altered mental status were analysed. Age range was 9 months to 15 years, median age of 34 months. 21 of 36 (58%) patients arrived out of hours. Application of electrodes was rated as ‘easy’ in 28 (77.8%) patients and rated as ‘difficult’ in 8 (22.2%). The utility of the EEG was rated by physicians as ‘very useful/diagnostic’ in 13 cases (36%), ‘useful’ in 21 cases (58%), ‘not useful’ in two cases (8%). None were rated ‘negative.’ConclusionUptake of pocEEG introduction has been very encouraging. Provider ratings were overwhelmingly positive. Recognition of non-convulsive status epilepticus was improved and pocEEG facilitated more targeted interventions.

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