Article Text

PDF

PO-0263 Safety Netting In Paediatric Emergency Care: A Systematic Review And Protocol Development
  1. E Kerkhof,
  2. D Geurts,
  3. M Wiggers,
  4. HA Moll,
  5. R Oostenbrink
  1. General Paediatrics, Erasmus University Medical Center - Sophia Children’s Hospital, Rotterdam, Netherlands

Abstract

Background Safety netting strategies after emergency department (ED) discharge are mostly not standardised.

Aim To develop a safety netting protocol for children at risk for serious infections (SI) discharged from the ED.

Methods Patients: Children with fever, vomiting/diarrhoea or dyspnoea (1 month-16 years).

Design: Systematic Literature Review to Select Best Evidence for Determinants of ED-Revisits and Prospective Cohort Study

Setting: ED of Erasmus MC-Sophia Children’s Hospital (May 2010–December 2012)

Intervention Standardised telephonic questionnaires on disease course three days after ED-discharge.

OutcomeED-Revisits with Intervention (Diagnostics or Treatment)

Analysis All determinants and time until ED-revisits were tested by multivariable logistic regression and Kaplan-Meier survival analysis.

Results (Preliminary) Follow-up data were available for 1366/1656(83%) children, median age 21 months (IQR10–45), 57% boys. 856(63%) were febrile children, 300(22%) children suffered from vomiting/diarrhoea and 210(15%) children had dyspnoea. Overall there were 401(29%) revisits in which 54% (n = 216) interventions were performed.

We confirmed the determinants: age <1 year, respiratory/circulatory symptoms and signs of dehydration, as identified in our systematic review, associated with ED-revisits. Additional, parental concern was a determinant for revisit in febrile children. Unscheduled revisits of children with vomiting/diarrhoea occurred mostly within one day and in febrile or dyspnoeic children within 2 days after initial ED-visit.

Discussion and conclusion We identified strong determinants of revisits by prospective data collection in ED-discharged children at risk for SI. We are preparing a multicentre efficacy study to use these determinants and time frames in ED safety netting management.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.