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[Pediatric emergency admission: results of two national surveys on a "given day"]
D Devictor1, M Cosquer, J Saint-Martin
1Unité de réanimation pédiatrique, hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Insights
Pediatric emergency admissions are often non-urgent, with only 10% of cases being genuine emergencies. Many hospitals lack sufficient pediatric specialists, highlighting the need for improved emergency care for children.
Area of Science:
- Pediatric Emergency Medicine
- Hospital Administration
- Public Health Policy
Context:
- Recent reforms in hospital emergency admissions primarily focused on adults.
- Pediatricians proposed improvements for child admissions, requiring statistical support.
- Investigations were conducted to gather data on pediatric emergency admissions in France.
Purpose:
- To investigate the nature and volume of pediatric emergency admissions in French hospitals.
- To assess the proportion of genuine emergency cases versus non-urgent consultations.
- To evaluate the availability of specialized pediatric medical staff in different hospital settings.
Summary:
- Two investigations in January 1994 and 1995 analyzed pediatric emergency admissions across French hospitals.
- Results indicated 60% of consultations were non-urgent, with only 10% deemed genuine emergencies; 30% involved accidental pathology.
- A significant disparity in pediatrician availability was noted between university and general hospitals, impacting pediatric emergency care.
Impact:
- Highlights the quantitative significance of pediatric emergencies and the need for specialized care.
- Emphasizes the variability in qualifications and specialization of staff managing pediatric emergencies.
- Underscores the necessity for improved hospital infrastructure and staffing to ensure appropriate and timely care for pediatric patients.
Background:
Recently, several measures were implemented to restructure the frame-work of hospital emergency admissions. However, these measures concern primarily adults. Pediatricians made on their own several proposals to improve admission of children. They felt that these proposals should be supported by statistical numbers. Several investigations were then conducted.
Population And Methods:
The authors report the results of two investigations conducted in January 1994 and January 1995 in all French hospitals admitting children in emergency.
Results:
The results shows that 60% of the purposes for consultations are of a general medical nature which does not require emergency assistance. The emergency cases were estimated genuine in only 10% of all incoming patients while all other cases were benign or treated merely as simple outpatient consultations. Accidental pathology represented 30% of all cases. More than half of the children were less than five years old. In most cases, a pediatrician was readily available night and day in all University hospitals which was, unfortunately, not the case in most general hospitals where the number of pediatricians was insufficient to assure night duties.
Conclusion:
The result of these investigations does not provide an exhaustive picture of the overall pediatric emergencies. It demonstrates, however, the quantitative importance of pediatric emergencies while emphasizing on their differentiation in qualifications and specialization of the practicians and nurses in charge of incoming patients from one hospital to another. It demonstrates that serious efforts need to be made so that the child may be readily directed to an hospital emergency center with appropriate medical and paramedical personnel, a situation which, unfortunately, does not always prevail at present.
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