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Published on: April 7, 2023
Epidemiology of the Critically Ill Child in the Resuscitation Bay
Insights
Critically ill children rarely require emergency department (ED) resuscitation, accounting for only 0.28% of visits. This study analyzed the spectrum of critical pediatric illnesses presenting to a tertiary care hospital, highlighting the need for preparedness.
Area of Science:
- Pediatric Emergency Medicine
- Critical Care Pediatrics
- Hospital Quality Improvement
Background:
- Children make up 33 million annual emergency department (ED) visits in the U.S.
- The spectrum and frequency of critically ill children in EDs remain underanalyzed.
Purpose of the Study:
- To analyze the range of critical illnesses in children presenting to a tertiary children's hospital ED.
- To determine the frequency of pediatric critical care encounters in an ED setting.
Main Methods:
- Retrospective chart review of pediatric patients requiring immediate care in the medical resuscitation bay.
- Data collected over a 25-month period (August 2005–September 2007) at a single academic, tertiary care pediatric hospital.
- Exclusion of trauma patients; analysis of illness type, frequency, arrival mode, and outcome.
Main Results:
- 249 pediatric patients required resuscitation bay care out of 87,766 total patients over 25 months.
- Critically ill children represented 0.28% of all ED visits.
- Complete data were available for 242 patients.
Conclusions:
- Pediatric critical care in the ED is infrequent at tertiary children's hospitals.
- Emphasizes the importance of established protocols, mock codes, and simulation labs for preparing for critically ill children.
Background:
Children account for approximately 33 million annual emergency department (ED) visits in the United States. The spectrum and frequency of children with a critical illness presenting to an ED has not been previously analyzed.
Objective:
The purpose of this study was to examine the range of critical illness presenting to a tertiary Children's Hospital ED.
Methods:
This study was a retrospective chart review of all pediatric patients requiring immediate care in the medical resuscitation bay during a 25-month period from August 2005 to September 2007. Data are from a single center, academic, tertiary care pediatric hospital. A log of all patients requiring immediate care is kept in the medical resuscitation bay. Patients recorded in the log for a period of 25 consecutive months were reviewed for type of critical illness, frequency of critical illness, mode of arrival, and outcome. Trauma patients were excluded.
Results:
There were approximately 45,000 pediatric visits per year with a total of 87,766 patients seen during the study period. There were 249 pediatric patients who required care in the medical resuscitation bay during the reviewed period. Complete data were obtained from 242 subjects' charts. Patients requiring immediate care accounted for 0.28% of all the visits.
Conclusions:
This study documents the infrequent need for pediatric critical care in the ED of a nonacademic tertiary children's hospital in the United States and reinforces the need to provide protocols, mock codes, and simulation labs in preparation for critically ill children.
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