Article Text

12 MONTHS IN A PORTUGUESE TERTIARY HOSPITAL’S PAEDIATRIC EMERGENCY ROOM
  1. J N Crispim1,2,
  2. L R Boto1,
  3. R Ferreira1,2,
  4. G AraujoESa1,2
  1. 1Child and Family Department, Santa Maria Hospital, Lisbon, Portugal
  2. 2Lisbon Medical Faculty, Lisbon University, Lisbon, Portugal

Abstract

Introduction Our tertiary hospital’s paediatric emergency room (PER) treats patients under 16 years of age from the community and referred by Portugal’s south and insular hospitals. It comprises an observation area. Since 2006 clinical data are digitally recorded, hence access was made easier.

Study Goal To identify reasons for attendance, medical attitudes and ulterior destinations.

Methods Episodes recorded in 2007 were retrospectively analysed using proper software.

Results Our PER registered 50 111 episodes (53.2% male gender; 53.5% <48 months old). Diagnosis was assigned in 54.0% of attendances, of which respiratory diseases accounted for 20.5% (34.8% common cold, 14.6% acute laryngitis, 13.9% asthma); signs/symptoms 15.1% (28% vomiting, 24.9% fever); infectious diseases 15.0% (48.4% acute tonsillitis); ear diseases 14.9% (89.5% otitis media); digestive tract diseases 12.6%. Laboratory tests were requested in 12.5% of episodes, imaging in 13.5%. 5.3% were admitted (60.8% of these to the observation area), 85.6% were discharged to community outpatient settings, 3.8% to a hospital outpatient setting. In the observation area 60.8% had assigned diagnosis, of which digestive tract diseases accounted for 24.5% (78.3% acute gastroenteritis); trauma/intoxications 22.8% (50.4% head trauma); respiratory diseases 16.5% (35.6% pneumonia, 30.5% acute bronchiolitis); signs/symptoms 16.0% (60.8% vomiting). Laboratory tests were requested in 57.9% and imaging in 21.7% of observation area episodes. 44.2% of observation area patients were further admitted in other units and 52.5% were discharged, staying on average 22.7 h.

Discussion Attending mostly infants and toddlers, respiratory diseases prevail, despite the higher admittance rate due to gastrointestinal diseases. Examination and admittance policies are fairly strict. Besides allowing self-evaluation, comparison between different paediatric settings has an inestimable relevance.

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