1104 Introducing a new paediatric clerking proforma in a tertiary paediatric emergency department – a quality improvement project

Abstract

Patients with injury severity score (ISS) of 8 and above were included in the review. Results A total of 227 records were identified, of these, 26.45% presented with major trauma (ISS>15). 177/227 (78%) of the cohort were aged 16-24 and managed by the adult trauma team while 50 (22%) were aged 10-15 years and managed by the paediatric team. Secondary transfers from trauma units accounted for 24.2% of cases. Weekly and monthly attendance trends are described in figure 1 and 2; These show that most patients above 16 years of age present with traumatic injuries between 22:00 and 8:00 with peaks in presentation in March and October. Between the age of 10 and 15 a daily peak was instead observed between 13:00 and 22:00. Isolated orthopaedic trauma and isolated head injuries were the most common diagnosis among the 10 to 15 age group, while polytrauma was encountered in almost 40% of presentations above 16 years of age. In the cohort examined, a total of 13 patients presented with stabbing injuries and these were mainly found in adolescents aged over 16 (84%). Mortality within 24 hours occurred in 3 patients aged respectively 11, 15 and 20. Among all patients, 19.38% where admitted in intensive care unit, with respectively 6.17% admission in paediatric intensive care and 13.21% admissions in general and neuro intensive care. Mean Inpatient stay for patients with ISS<9 was 5.5 days (±11.65) with similar figures for patients with moderate trauma (5.55 ±6.04 days), whereas, for patients with ISS>15 an average of 14.03 days (±18.23) was observed.