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[Pediatric emergencies attended at a primary care clinic (II): Epidemiological study]
G Fernández Cano1, G Martín Carballo
1Pediatras de Equipo de Atención Primaria, Madrid.
Insights
Pediatric emergency visits are often due to fever and catarrh in younger children, and trauma in older children. Primary care effectively manages most pediatric emergencies, with trauma being the main reason for hospital referrals.
Area of Science:
- Pediatric Emergency Medicine
- Primary Care Pediatrics
- Public Health
Background:
- Pediatric emergency clinics manage a wide range of childhood illnesses and injuries.
- Understanding reasons for consultation, diagnoses, and treatments is crucial for optimizing primary care services.
- Primary care plays a vital role in managing pediatric health issues and acting as a gatekeeper for hospital services.
Purpose of the Study:
- To analyze reasons for consultation, diagnoses, treatments, further tests, resolution rates, referrals, and personal history in a pediatric emergency clinic.
- To evaluate the effectiveness of primary care in managing pediatric emergencies.
- To identify key differences in reasons for consultation and diagnoses based on age groups.
Main Methods:
- A prospective, longitudinal study conducted over one year (July 1996-June 1997) at an urban pediatric primary care clinic.
- Inclusion of 2890 registered children aged 0-14 years.
- Data collection on reasons for consultation, diagnoses, treatments, further tests, resolution, and referrals for 723 attended emergencies.
Main Results:
- Fever (42.7%) and catarrh (18.9%) were the most common reasons for consultation in younger children, while trauma (9.1%) predominated in older children.
- Tonsillitis/ENT focus (21.7%) and upper passage catarrh (15.9%) were leading diagnoses in under-10s; trauma was most common in over-10s.
- Most common treatments included antithermics/analgesics (41.8%) and antibiotics (19.7%). X-rays (44.9%) and urine cultures (43.4%) were frequent further tests. Trauma treatments were common at the health center, and 95.8% of consultations were resolved.
Conclusions:
- Fever, catarrh, and tonsillitis are common in younger children, while trauma is prevalent in older children presenting to pediatric emergency care.
- Primary care settings are effective in managing a significant proportion of pediatric emergencies, particularly trauma.
- Trauma represents the primary reason for referrals to higher levels of care, highlighting the need for specialized management strategies.
Objectives:
To analyse the reasons for consultation (RC), diagnoses, treatments, further tests (FC), whether resolved at PC level, referrals and personal history, at a paediatrics emergency clinic.
Design:
A prospective, longitudinal study, during the working days of alternate weeks between July 1 1996 and June 30 1997.
Setting:
Urban paediatrics clinic, on the afternoon shift (2 to 9 p.m.), of the Vicente Soldevilla Primary Care Team (PCT) in Vallecas (Madrid).
Participants:
Population registered with the PCT: 2890 children between 0 and 14.
Results:
723 emergencies were attended. The main RC were: temperature (42.7%), catarrh (18.9%) and physical traumas (9.1%). The most common diagnoses were: tonsillitis/ENT focus (21.7%), upper passage catarrh (UPC) (15.9%) and acute gastro-enteritis (8.3%). 18.8% had some further test (x-rays 44.9% and urine cultures 43.4%). The most common treatments were antithermic, analgesic and anti-inflammatory drugs (41.8%), antibiotics (19.7%), oral tolerance and/or diets (9.8%) and trauma treatment (5.2%). 14.9% were treated at the health centre, 69.5% of which were trauma treatments. 95.8% of the consultations were resolved. The most common referrals (78.2%) were due to trauma.
Conclusions:
Temperature and catarrh symptoms were the most common RC in children under 10, and trauma in children over 10. Tonsillitis/ENT focus and UPC were the most common diagnoses in the under-10s, and trauma in the over-10s. Most requested further tests were X-rays and urine cultures. Most commonly prescribed medicines were antithermic, analgesic and anti-inflammatory drugs. Mainly trauma treatments were done at the health centre. Primary care is an effective filter of hospital emergencies. Traumas were the main cause of referrals to hospital.