Differences in Utilisation of the General and Paediatric Emergency Departments by Paediatric Patients

Area of Science:

• Emergency Medicine
• Pediatric Care
• Healthcare Management

Background:

• Paediatric patients presenting to general emergency departments (EDs) differ from those in specialized paediatric EDs.
• General EDs exhibit varying levels of preparedness for paediatric emergencies, potentially impacting clinical outcomes.
• Understanding these differences is vital for improving care delivery.

Purpose of the Study:

• To elucidate the differences in utilisation patterns between paediatric and general EDs for paediatric patients.
• To compare the characteristics and outcomes of paediatric patients managed in different ED settings.

Main Methods:

• Retrospective review of medical records of paediatric patients (<16 years) attending EDs in Singapore from January 2015 to December 2018.
• Data collected using a standardised form and analysed.
• Comparison of patient demographics, presentation categories, diagnoses, and mortality between general and paediatric EDs.

Main Results:

• General EDs managed a higher proportion of emergent (P1) paediatric cases (5.1% vs 2.2%) and trauma presentations (37.0% vs 15.9%) compared to paediatric EDs.
• Overall paediatric mortality was low, but significantly higher in general EDs (0.2% vs 0.005%).
• Top diagnoses in general EDs for emergent paediatric cases included seizure, asthma/bronchitis/bronchiolitis, allergic reaction, cardiac arrest, and burns.

Conclusions:

• General EDs require enhanced capabilities and preparedness to effectively manage the paediatric population they serve.
• Optimising paediatric emergency care, especially for critically ill patients, necessitates improved resources and training in general EDs.
• Timely and life-saving treatment for paediatric emergencies can be compromised without adequate general ED preparedness.