Scoping a paediatric emergency medicine unit.

Area of Science:

• Emergency Medicine
• Paediatric Care
• Health Services Research

Background:

• Tertiary mixed adult/paediatric emergency departments (EDs) manage a high volume of paediatric presentations annually.
• The establishment of a paediatric emergency medicine unit (PEMU), or short stay unit, can optimize care for specific paediatric patient cohorts.
• Defining suitable patient profiles and diagnoses is crucial for the successful implementation and operation of a PEMU.

Purpose of the Study:

• To characterize paediatric patient presentations at Canberra Hospital ED.
• To identify patient cohorts and diagnoses suitable for a newly proposed paediatric emergency medicine unit (PEMU).
• To assess the potential daily patient volume and resource requirements for a PEMU.

Main Methods:

• Retrospective descriptive study of paediatric (<16 years) ED presentations at Canberra Hospital from May to August 2022.
• Patients with ED length of stay >4 hours or non-surgical admission <2 nights were classified as PEMU-suitable.
• Clinical practice guidelines were utilized to assess disease severity based on ED findings.

Main Results:

• Of 8,340 paediatric ED episodes, 1,377 (64.8%) were retrospectively identified as PEMU-suitable.
• An average of 11.9 potential PEMU-suitable cases were identified daily during the study period.
• Common diagnoses like mild bronchiolitis, mild asthma, and simple febrile seizures showed low inpatient ward admission rates (≤17%) and were well-suited for PEMU.

Conclusions:

• Several common paediatric diagnoses are appropriate for management within a PEMU, demonstrating feasible occupancy and length of stay.
• The low inpatient admission rate for identified conditions suggests that less common paediatric diagnoses may also be suitable for PEMU care.
• Further research is recommended to identify additional paediatric patient groups and diagnoses suitable for PEMU and to validate findings across a full year.