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Scoping a paediatric emergency medicine unit.

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A paediatric emergency medicine unit (PEMU) can effectively manage common childhood illnesses like bronchiolitis and asthma, with low admission rates. Further research is needed to expand suitable patient cohorts for PEMU.

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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.