How do critically ill children present to a local emergency department?

Abstract

Objective: To describe the profile of critically ill paediatric patients presenting to a local emergency department. Methods: This was a retrospective review of all triage Category 1 (critical) children aged from 0 to 16 years presenting to the emergency department of Queen Mary Hospital. The study period was from January 1998 to September 2006. Results: A total of 277 patients were analyzed. Trauma was a major cause of presentation. It constituted 37.9% of the cases. Of the trauma cases, head injury was the most common. For non-trauma cases, convulsion was the commonest reason of attendance. Cardiorespiratory arrest was uncommon (3.6%). The overall mortality rate was 7.6%. A high proportion (43.3%) of the patients was managed solely by staff of the emergency department. Resuscitative procedures, such as intraosseous line, were infrequently practised. Conclusion: Trauma and convulsion were the major presentations of critically ill children. The fact that A&E staff managed a high proportion of the cases alone and the infrequent practice of resuscitative procedures make continuous training in paediatric resuscitation particularly important.