Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
Accident and Emergency Department, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
BMC Pediatr. 2021 Apr 14;21(1):172. doi: 10.1186/s12887-021-02646-8.
Pediatric patients present to Emergency Departments (EDs) with a variety of medical conditions. An appreciation of the common presenting conditions can aid EDs in the provision of pediatric emergency care. In this study, we established the common pediatric diagnoses seen at the general EDs, with reference to a pediatric ED.
A retrospective review of medical records was performed for patients less than 16 years old at a pediatric ED and two general EDs from 1 January to 31 December 2018. Information including patient demographics, triage category, case type and diagnoses were collected.
There were 159,040 pediatric attendances, of which 3477 (2.2%) were seen at the general EDs. Non-traumatic conditions were most prevalent at both general (N = 1933, 55.6%) and pediatric (N = 128,415, 82.5%) EDs. There was a higher proportion of trauma related conditions seen at the general EDs (N = 1544, 44.4%) compared to the pediatric ED (N = 27,148, 17.5%; p < 0.01). Across all EDs, upper respiratory tract infection, unspecified musculoskeletal pain and gastroenteritis were the three most common non-trauma related diagnoses, while fracture, wound and contusion were the three most common trauma related diagnoses. There was a greater proportion of emergent (P1) cases seen at the general EDs (N = 233, 6.7%) than the pediatric ED (N = 3821, 2.5%; p < 0.01). Respiratory conditions including bronchiolitis, asthma and bronchitis were the most common emergent (P1) diagnoses.
The common diagnoses among pediatric attendances varied between pediatric and general EDs. Therefore, general EDs should focus their efforts on these common diagnoses, especially the emergent (P1) ones, so that they can enhance their preparedness and work towards providing quality pediatric emergency care.
儿科患者因各种医疗状况就诊于急诊科。了解常见的就诊情况可以帮助急诊科提供儿科急诊护理。在这项研究中,我们参考儿科急诊科,确定了普通急诊科常见的儿科诊断。
对 2018 年 1 月 1 日至 12 月 31 日期间在儿科急诊科和两家普通急诊科就诊的 16 岁以下患者的病历进行回顾性分析。收集的信息包括患者人口统计学、分诊类别、病例类型和诊断。
共有 159040 名儿科就诊者,其中 3477 名(2.2%)在普通急诊科就诊。非创伤性疾病在普通急诊科(N=1933,55.6%)和儿科急诊科(N=128415,82.5%)均最为常见。普通急诊科创伤相关疾病的比例较高(N=1544,44.4%),而儿科急诊科较低(N=27148,17.5%;p<0.01)。在所有急诊科中,上呼吸道感染、未特指的肌肉骨骼疼痛和胃肠炎是非创伤性相关诊断中最常见的三种疾病,而骨折、伤口和挫伤是创伤性相关诊断中最常见的三种疾病。普通急诊科紧急(P1)病例的比例较高(N=233,6.7%),而儿科急诊科较低(N=3821,2.5%;p<0.01)。呼吸道疾病包括细支气管炎、哮喘和支气管炎是最常见的紧急(P1)诊断。
儿科就诊者的常见诊断在儿科急诊科和普通急诊科之间存在差异。因此,普通急诊科应重点关注这些常见诊断,特别是紧急(P1)诊断,以便提高准备度,努力提供优质的儿科急诊护理。