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Emergency department assessment and management of children with gastroenteritis
Kimberley Robson1, Stéphane Bouchoucha2, Julie Considine3
1School of Nursing and Midwifery, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia; Emergency Department, Alice Springs Hospital, 6 Gap Road, Alice Springs, Northern Territory 0870, Australia.
Insights
Emergency department care for acute gastroenteritis in young children is generally effective, though moderate dehydration and Aboriginal child management require further investigation. Assessment and documentation can be improved.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
Background:
- Acute gastroenteritis is a significant cause of illness and death in children.
- Effective management in emergency departments (EDs) is crucial.
Purpose of the Study:
- To evaluate the assessment and management of acute gastroenteritis in children aged 6-48 months in the ED.
- Identify areas for improvement in pediatric gastroenteritis care.
Main Methods:
- Retrospective cohort study of 340 children aged 6-48 months.
- Medical record audit of ED presentations between January 1 and December 31, 2019.
Main Results:
- General assessments were appropriate; dehydration assessment, BP monitoring, and fluid balance charting need improvement.
- Management aligned with guidelines for severe/mild dehydration, with variability in moderate dehydration cases.
- No significant differences in dehydration severity or pathology between Aboriginal and non-Aboriginal children, but management strategies differed.
Conclusions:
- ED management of pediatric gastroenteritis largely meets or exceeds evidence-based recommendations.
- Variability in managing moderate dehydration and Aboriginal children warrants further research to determine if care is suboptimal or patient-specific.
- The study highlights specific areas for future research in this clinical context.
Background:
Acute gastroenteritis is a major cause of morbidity and mortality in children. The aim of this study was to explore assessment and management of children aged between 6 and 48 months presenting to the emergency department (ED) with acute gastroenteritis.
Methods:
This retrospective cohort study included 340 children aged 6-48 months. Data were collected by medical record audit for children presenting between 1 January and 31 December 2019.
Results:
General assessments were appropriate, specific dehydration assessment, blood pressure measurement and fluid balance chart documentation could be improved. Management of children with severe or no/mild dehydration was largely compliant with current recommendations: there was variability in management of children with moderate dehydration. There were no significant differences between Australian Aboriginal and non-Aboriginal children in terms of dehydration severity and pathology abnormalities, however there were differences in management strategies.
Conclusions:
ED management of children with gastroenteritis was largely consistent with, or superior to, evidence-based recommendations. There was variability in the management of children with moderate dehydration and Australian Aboriginal children but it is unclear whether this is suboptimal or patient specific care. This study has highlighted areas for further research in this unique context.
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