Too old for a paediatric emergency department? It's complex

Ir J Med Sci. 2020 Nov;189(4):1429-1433. doi: 10.1007/s11845-020-02213-7. Epub 2020 Mar 16.

Abstract

Background: In Ireland, the paediatric emergency department (PED) is tasked with acute healthcare provision to children and adolescents under 16 years of age. The population > 15 years attending the PED remains undescribed.

Aims: The objective of the study is to describe the presentations of patients > 15 years to the PED of a national tertiary academic paediatric hospital.

Methods: A retrospective review of electronic records identifying all patients (> 15 years) who presented from January 2014 to December 2015. Patient demographics, presenting complaint, diagnosis, treatment and disposition were recorded.

Results: A total of 71,082 patients attended during the study period; of whom, 426 (0.6%) patients were aged 16 to 61 years. Over half were identified as having clearly defined chronic complex conditions. Three hundred and forty-five (89%) patients were known to the hospital paediatric services and under the care of specialist with 131 (34%) patients admitted locally, all of whom had chronic complex conditions (CCC). There was a total of 44 (11%) patients who presented to the PED with de novo issues and had a variety of acute presenting complaints with minor injuries, syncope and chest pain being most common.

Conclusion: This is the first Irish study demonstrating a significant population (> 15 years) with medical complexity that requires a suite of services in a paediatric hospital which is accessed in an unscheduled manner through an emergency department. We recommend further research to describe paediatric CCC attending Irish emergency and hospital services.

Keywords: Chronic complex conditions; Emergency services; Paediatric emergency medicine.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / standards*
  • Female
  • Hospitals, Pediatric / standards*
  • Humans
  • Male
  • Retrospective Studies