One year experience at the Emergency Unit of the Children’s Hospital of Parma

Abstract

The objective of the study was to analyse the activity of the Paediatric Emergency Unit (PEU) of the Children’s Hospital in Parma, Italy, in the first year of its functioning. To this aim, the child’s chronological age, place of origin (town or province), ethnic group, cause of consultation, time and date of admission, diagnosis and final destination were retrospectively collected from the clinical notes of all children who attended PEU from 1st. 10.1998 to 30th. 09.1999. During the period of this study 8,564 medical consultations (57% of users were male) were carried out by the Paediatricians on duty in the EU of The Children’s Hospital. The average age of the patients was 3.9±3.5 years. Only 7% of patients passed through the General Emergency Department of the same Hospital. The peak period of consultations was found to be in February. The number of daily attendances progressively increased from Monday to Sunday according to a r of 0.59 (p<0.02) with a peak during the weekend. The most frequent causes for attendance concerned infections in the upper respiratory tract (36%), gastroenteritis (22%) and injuries (12%). Attendance, consultation and discharge procedures were covered at an average interval of 36.1±15.6 minutes (median 30 min.). Seventy per cent of the patients were discharged, 56.7% were males. Fourteen per cent of the rest were admitted for a short period of observation in the beds of the PEU and 16% in beds of specialised wards in the PD. Eighty per cent of admissions at the PEU lasted less than 48 hours. The analysis of the data collected at the PEU of our PD during the first year of its activity highlights the huge amount of work carried out by the Paediatricians on duty. To solve the abnormal admittance to a PEU, a complete reorganization of the Family Paediatricians network has to be hoped for. Special attention must also be addressed to the users of a PEU in order to reduce their attendance.To reach this target a continuous health education and information program for the general population and first-time parents has to be planned. Beyond these considerations, there is not doubt that a PEU requires a specific medical and nursing staff in order to prevent the service becoming ineffective.