Arch Dis Child 2001;84:390-392 ( May )

Article

Audit

Determining the common medical presenting problems to an accident and emergency department K Armon^a, T Stephenson^a, V Gabriel^a, R MacFaul^b, P Eccleston^a, U Werneke^c, S Smith^d

^a Academic Division of Child Health, School of Human Development, Medical Faculty, University of Nottingham, Nottingham NG7 2UH, UK, ^b Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, UK, ^c Maudsley Hospital, London SE5 8AZ, UK, ^d Queens Medical Centre, Nottingham NG7 2UH, IK

Correspondence to: Dr Armon mk.armon{at}ntlworld.com

Accepted 21 November 2000

All accident and emergency (A&E) attendances over a one year period were prospectively studied in order to determine common medical presenting problems. Data were collected on children (0-15 years) attending a paediatric A&E department in Nottingham between February 1997 and February 1998. A total of 38 982 children were seen. The diagnoses of 26 756 (69%) were classified as trauma or surgical, and 10 369 (27%) as medical; 1857 (4%) could not be classified. The commonest presenting problems reported for "medical" children were breathing difficulty (31%), febrile illness (20%), diarrhoea with or without vomiting (16%), abdominal pain (6%), seizure (5%), and rash (5%). The most senior doctor seeing these patients in A&E was a senior house officer (intern or junior resident) in 78% of cases, paediatric registrar (senior resident) in 19%, consultant (attending physician) in 1.4%, and "other" in 2.6%. Guidelines developed for A&E should target the commonest presenting problem categories, six of which account for 83% of all medical attendances, and be directed towards senior house officers.


Keywords: accident and emergency; hospital admission; diagnosis

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© 2001 by Archives of Disease in Childhood
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