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.