Emergency Medicine: Open Access
Open Access

Abstract

The Peculiarity of Presenting Signs and Symptoms among Paediatric Patients Aged Less than 16 Years in a Mixed University Emergency Department

Ruth M Löllgen, Pagona Chouchou, Christian T Braun, Daniel Garcia, Aristomenis K Exadaktylos and Steffen Berger

Background: Most paediatric emergency departments (PED) in Switzerland are now interdisciplinary. Prior to that, a considerable number of children randomly presented to both the tertiary mixed adult and formerly separated medical and surgical paediatric EDs at Inselspital Bern.
Aim of the study: To review the specific presenting signs and symptoms, outcome and reason for presentation to the adult ED among paediatric patients prior to the opening of the interdisciplinary PED in January 2013.
Methods: A standardised activity-based hospital database system was used to identify all children aged less than 16 years presenting to the tertiary adult ED over a 10-year period (2001-2011). Patient demographics, reason for presentation, investigations performed, treatment administered and outcome were recorded and analysed retrospectively. Results: Data of 554 eligible patients were analysed. Otorhinolaryngeal (ORL) symptoms (73.5%, n=407) predominated by far, followed by surgical issues (10.7%, n=59). Computed tomography (CT), conventional X-rays, low dose X-ray (LODOX®) scanner and magnetic resonance imaging (MRI) were required in 7.8%, 6.9%, 0.4% and 0.5% of all cases, respectively. Logistical reasons, the need for subspecialty referral and random parental choice were the main reasons to present to the adult ED.
Conclusion: Our findings highlight the high frequency of ORL illness and the requirement for imaging in at least 8% of the paediatric population presenting to the adult ED, strongly encouraging the addition of CT/MRI to larger PEDs. Paediatric Emergency Medicine (PEM) trained medical and nursing staff should be upsized, thus constituting an ideal environment to manage seriously ill and injured children.