Epidemiology of Pediatric Emergency Department Use at an Urban Medical Center

Zimmer, Karen P.; Walker, Allan David; Minkovitz, Cynthia S.

doi:10.1097/01.pec.0000159050.19188.23

Cited by 47 publications

(35 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…8,10,13,14,21 Nevertheless, the literature suggests that frequent use of the ED for nonemergent care is not the primary cause of overcrowding. 26,27 We noted a relatively high admission rate on the second visit. DePiero et al 11 looked at children admitted on the second visit to a PED and found that 90% had an appropriate ED evaluation, and admission was for progression of illness ( Figure 6).…”

Section: Discussionmentioning

confidence: 94%

Early Pediatric Emergency Department Return Visits

Ali

Place

Howell

et al. 2012

Clin Pediatr (Phila)

View full text Add to dashboard Cite

Among children who are discharged from the emergency department and return within 72 hours, most caregivers are satisfied with the care and instructions provided on their first visits. Though most patients have a PMD, many do not call them prior to their return ED visit, and those who do either cannot schedule an appointment or are told to return to the ED. The majority of patients return for clinical progression of illness.

show abstract

Section: Discussionmentioning

confidence: 94%

Early Pediatric Emergency Department Return Visits

Ali

Place

Howell

et al. 2012

Clin Pediatr (Phila)

View full text Add to dashboard Cite

show abstract

“…14,15 However, these studies may be affected by different biases, including spectrum bias, as under-represented minorities are more likely to identify the ED as their usual source of health care 16–19 and use the ED for nonurgent care. 20 Therefore, among other reasons, these differences may be more of a reflection of racial and ethnic differences in ED use rather than ED management, as minorities may be more likely to present to the ED for nonsurgical or less intense causes of abdominal pain. 21 Appendicitis is the most common surgical cause of abdominal pain in the ED and the provision of analgesia to patients with appendicitis is now accepted and encouraged.…”

mentioning

confidence: 99%

Racial Disparities in Pain Management of Children With Appendicitis in Emergency Departments

et al. 2015

View full text Add to dashboard Cite

“…[1][2][3] This leads to overcrowded waiting rooms and long waiting times. As a consequence, patients needing care urgently may not be treated in time, whereas patients with non-urgent problems may unnecessarily receive expensive emergency care.…”

mentioning

confidence: 99%

Validity of the Manchester Triage System in paediatric emergency care

Roukema

Steyerberg²,

Meurs

et al. 2006

Emergency Medicine Journal

107

View full text Add to dashboard Cite

Objective: To assess the validity of the Manchester Triage System (MTS) in paediatric emergency care, using information on vital signs, resource utilisation and hospitalisation. Methods: Patients were eligible if they had attended the emergency department of a large inner-city hospital in The Netherlands from August 2003 to November 2004 and were ,16 years of age. A representative sample of 1065 patients was drawn from 18 469 eligible patients. The originally assigned MTS urgency levels were compared with resource utilisation, hospitalisation and a predefined reference classification for true urgency, based on vital signs, resource utilisation and follow-up. Sensitivity, specificity and percentage of overtriage and undertriage of the MTS were calculated. Results: The number of patients who used more than two resources increased with a higher level of MTS urgency. The percentage of hospital admissions increased with the increase in level of urgency, from 1% in the non-urgent patients to 54% in emergent patients. According to the reference classification, the sensitivity of the MTS to detect emergent/very urgent cases was 63%, and the specificity was 78%. Undertriage occurred in 15% of patients, of which 96% were by one urgency category lower than the reference classification. Overtriage occurred in 40%, mostly in lower MTS categories. In 36% of these cases, the MTS classified two or more urgency categories higher than the reference classification. Conclusions: The MTS has moderate sensitivity and specificity in paediatric emergency care. Specific modifications of the MTS should be considered in paediatric emergency care to reduce overtriage, while maintaining sensitivity in the highest urgency categories.H ospital emergency departments are increasingly visited by patients with non-urgent problems.1-3 This leads to overcrowded waiting rooms and long waiting times. As a consequence, patients needing care urgently may not be treated in time, whereas patients with non-urgent problems may unnecessarily receive expensive emergency care. Therefore, a reliable, valid triage system is required for patient safety. Triage of paediatric patients is difficult as presenting signs and symptoms and final diagnoses differ from those of adults.4 Several triage systems have been developed to categorise patients by urgency of care.5-12 The Manchester Triage System (MTS), used by emergency department nurses, is a triage system that supports the determination of a patient's urgency level on the basis of discriminators embedded in problem-specific flow charts. 13The triage nurse selects the most suitable flow chart for each presenting problem and uses general and specific discriminators to identify the patient's acuity. The MTS provides clarity about maximum allowed waiting time for the different levels of urgency: ''emergent'' (red) needs instantaneous evaluation, ''very urgent'' (orange) needs evaluation within 10 min, ''urgent'' (yellow) within 60 min, ''standard'' (green) within 120 min and ''non-urgent'' (blue) can wait for up to ...

show abstract

Epidemiology of Pediatric Emergency Department Use at an Urban Medical Center

Cited by 47 publications

References 16 publications

Early Pediatric Emergency Department Return Visits

Early Pediatric Emergency Department Return Visits

Racial Disparities in Pain Management of Children With Appendicitis in Emergency Departments

Validity of the Manchester Triage System in paediatric emergency care

Contact Info

Product

Resources

About