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Emergency department use by infants less than 14 days of age
T J T Kennedy1, L K Purcell, J C LeBlanc
1Department of Pediatrics, Dalhousie University and IWK Grace Health Centre, Halifax, Nova Scotia.
Insights
First-time mothers and young mothers are more likely to bring their infants to the emergency department (ED) for non-urgent reasons. Perinatal education for these groups can help reduce unnecessary ED visits.
Area of Science:
- Pediatrics
- Emergency Medicine
- Public Health
Background:
- Infant emergency department (ED) visits are common.
- Understanding factors leading to non-urgent ED visits is crucial for resource optimization.
Purpose of the Study:
- To identify factors associated with non-acute presentations to the emergency department (ED) for infants under 14 days old.
Main Methods:
- A prospective survey was conducted in a pediatric ED.
- Infants under 14 days presenting to the ED were assessed.
- Non-acute presentation was defined by specific criteria including no physician referral, non-urgent triage, no investigations, and home discharge.
Main Results:
- Nearly half (49%) of infant ED visits were classified as non-acute.
- Primiparous mothers had a significantly higher proportion of non-acute infant ED visits (64%) compared to multiparous mothers (24%).
- Mothers younger than 25 years were more likely to present infants for non-acute reasons.
Conclusions:
- Primiparity and maternal age under 25 are linked to non-acute infant ED visits.
- Neonatal discharge timing did not influence the acuteness of ED presentation.
- Targeted perinatal education for first-time and young mothers may reduce non-acute ED visits.
Objective:
To determine the factors associated with nonacute presentation to the emergency department (ED) by infants less than 14 days of age.
Methods:
A prospective survey was conducted in the pediatric ED of a teaching hospital providing voluntary in-home follow-up for families discharged within 48 hours of delivery. Participants were families of infants less than 14 days of age presenting to the ED over a 1-year period. The main outcome measure was acuteness of presenting problem. Presenting problems were classified as nonacute if the following 4 criteria were met: (i) no physician referral; (ii) nonurgent triage code assigned by a triage nurse; (iii) no investigations performed in the ED; and (iv) discharge home.
Results:
Of the 142 eligible infants, 70 (49%) infants presented with nonacute problems. Ninety-two (65%) returned questionnaires. There was no significant difference in the proportion of nonacute problems between infants discharged at less than 48 hours of age and those discharged at more than 48 hours (P = 0.7). The proportion of nonacute problems among infants of primiparous mothers was significantly higher (64%) than among infants of multiparous mothers (24%) (P < 0.001). Infants of mothers less than 25 years of age were more likely to present with nonacute problems (P = 0.002).
Conclusions:
Primiparity and maternal age less than 25 years were associated with nonacute ED presentation. Acuteness of presentation to the ED was not influenced by timing of neonatal discharge. Therefore, perinatal education might be best targeted at first time mothers and young mothers to reduce the number of nonacute ED visits.
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