Abstract
Background 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.
Objectives We aimed to determine the common pediatric diagnoses seen, and how they differed between pediatric-only and general EDs.
Methods A retrospective review of medical records was performed for patients less than 16 years old at a pediatric ED and three general EDs from 1 January to 31 December 2018. Information including patient demographics, triage category, case type and diagnoses were collected.
Results There were 161,375 pediatric attendances, of which 155,563 (96.4%) were seen at the pediatric ED. Non-traumatic conditions were most prevalent in both pediatric (N=128,415, 82.5%) and general EDs (N=3,506, 60.3%). Trauma related conditions were more commonly seen in general EDs (N=2,306, 39.7%) compared to the pediatric ED (N=27,148, 17.5%; p<0.01). Across all EDs, fracture, wound and head injury were the three most common trauma related diagnoses, while upper respiratory tract infection, unspecified fever and gastroenteritis were the three most common non-trauma related diagnoses. There was a greater proportion of emergent (P1) cases seen in general EDs (N=277, 4.8%) than the pediatric ED (N=3,821, 2.5%; p<0.01). Respiratory conditions including bronchiolitis, asthma and bronchitis were the most common emergent (P1) diagnoses.
Conclusions Understanding the common pediatric diagnoses presenting at EDs can facilitate clinical guidelines implementation, resource allocation and staff training. By focusing efforts on emergent (P1) diagnoses, general EDs can enhance their preparedness and quality of pediatric emergency care to critically ill patients.