PT  - JOURNAL ARTICLE
AU  - Armon, K
AU  - Stephenson, T
AU  - Gabriel, V
AU  - MacFaul, R
AU  - Eccleston, P
AU  - Werneke, U
AU  - Smith, S
TI  - Determining the common medical presenting problems to an accident and emergency department
AID  - 10.1136/adc.84.5.390
DP  - 2001 May 01
TA  - Archives of Disease in Childhood
PG  - 390--392
VI  - 84
IP  - 5
4099  - http://adc.bmj.com/content/84/5/390.short
4100  - http://adc.bmj.com/content/84/5/390.full
SO  - Arch Dis Child2001 May 01; 84
AB  - 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.