Bolic Marita S, Lew Jamie, Richardson Drew B
James Cook University, College of Medicine and Dentistry, Cairns, Queensland, Australia.
Paediatric Emergency Medicine, Emergency Department, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia.
Emerg Med Australas. 2025 Apr;37(2):e70033. doi: 10.1111/1742-6723.70033.
To describe the characteristics and potential patient cohorts suitable for a paediatric emergency medicine unit (PEMU), otherwise known as a short stay unit, at Canberra Hospital, a tertiary mixed adult/paediatric ED treating 98 000 patients annually.
Retrospective descriptive study of paediatric (aged <16) presentations to Canberra Hospital ED between May and August 2022. Patients discharged from ED with a length of stay exceeding 4 h and those admitted non-surgically for less than 2 nights were deemed PEMU suitable; those requiring admission for >2 nights were classed as inpatient ward admission (IWA) patients. Royal children's hospital clinical practice guidelines were used where available to classify the severity of disease via features apparent in ED.
Eight thousand three hundred and forty episodes were identified as paediatric ED presentations, with 1377 (64.8%, 95%CI 62.8-66.9) retrospectively PEMU suitable. This winter sample identified an average of 11.9 potential PEMU suitable cases daily. Chart review showed clinically mild bronchiolitis, mild asthma, anaphylaxis, mild gastroenteritis, afebrile seizure - no known seizure diagnosis, and simple febrile seizures had an excellent profile for PEMU, with subsequent ward admission rates of 17% or less. A mean 7-h stay would require 5 beds with 66% occupancy over 24 h.
Several common paediatric diagnoses are well-suited to a PEMU unit, with reasonable occupancy and length of stay. The low inpatient admission rate suggests less common diagnoses should also be regarded as suitable. Further research is required to identify other paediatric patients and diagnoses suitable for PEMU, and to ratify findings in a whole-of-year sample.
描述适合堪培拉医院儿科急诊科（PEMU，也称为短期留观病房）的患者特征及潜在患者群体。堪培拉医院是一家三级综合性成人/儿科急诊科，每年接待98000名患者。
对2022年5月至8月期间到堪培拉医院急诊科就诊的儿科患者（年龄<16岁）进行回顾性描述性研究。急诊留观时间超过4小时后出院的患者以及非手术住院时间少于2晚的患者被视为适合入住PEMU；那些需要住院超过2晚的患者被归类为住院病房收治（IWA）患者。如有可用的皇家儿童医院临床实践指南，则通过急诊科明显的特征对疾病严重程度进行分类。
共识别出8340例儿科急诊病例，其中1377例（64.8%，95%CI 62.8 - 66.9）经回顾性分析适合入住PEMU。今年冬季样本显示，每天平均有11.9例潜在适合入住PEMU的病例。病历审查显示，临床上轻度细支气管炎、轻度哮喘、过敏反应、轻度胃肠炎、无已知癫痫诊断的发热性惊厥以及单纯性发热性惊厥非常适合入住PEMU，随后的病房收治率为17%或更低。平均住院7小时需要5张床位，24小时内床位占用率为66%。
几种常见的儿科诊断非常适合PEMU病房，占用率和住院时间合理。低住院收治率表明，不太常见的诊断也应被视为适合。需要进一步研究以确定其他适合PEMU的儿科患者和诊断，并在全年样本中验证研究结果。
