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G106(P) Inappropriate ambulance use in paediatrics
  1. K Blundell,
  2. E Abrahamson
  1. Chelsea and Westminster Hospital, NHS, London, UK


The use of the ambulance service and emergency department for non-urgent needs is considered a significant contributor to health system inefficiencies and a financial stressor. We performed a retrospective audit of children “inappropriately” transferred to a central London paediatric emergency department (PED) by ambulance during the period February to April of 2014. Inappropriate ambulance transfer was defined as children over the age of 2 years who did not require interventions or investigations in the PED, who had not been advised to call an ambulance by 111 or primary care services, and whose presenting complaints or diagnoses did not have any features which might be interpreted as worrying by non-medically trained caregivers. 512 patients were transferred to the PED by ambulance during the study period, of these 102 (20%) were admitted to hospital. 309 (60%) did not require any investigations or interventions (excluding observations and simple analgesia) and of these, 174 (33%) were thought to represent potentially avoidable and “inappropriate” ambulance transfers. With finite resources and pressures on both the London ambulance service and PED services, research identifying reasoning behind caregiver choices, their understanding of healthcare options and the provision of further education and health information represent worthwhile steps in tackling this issue.

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