G106(P) Inappropriate ambulance use in paediatrics

Abstract

Results Mean age at presentation is 5.2 years (SD 1.8) [one month-15 years]. During the sampled time frame (01/06/14-31/ 08/14) there were a total of 54 presentations with a discharge diagnosis of conjunctivitis. 86% (25/29) were correctly diagnosed bacterial conjunctivitis. 52% (13/25) were correctly diagnosed allergic conjunctivitis. 30 of the patients had documented features of bacterial conjunctivitis. 40% (12/30) had an eye swabs taken. A total of 13 eye swabs were taken of which only one was indicated. 86% appropriately treated with topical antibiotics. 85% appropriately treated with antihistamines. 7% (3/41) were inappropriately treated with antihistamines. 28% (15/54) were referred for specialist opinion. Discussion Conjunctivitis is a common presentation to a paediatrics emergency department. Indiscriminate use of microbiological investigations is a significant financial burden to the hospital and one, which can be easily eradicated. Prescribing of topical antibiotics or oral antihistamines should be based on sound clinical grounds so as to avoid unnecessary medicating of patients. Specialist referrals should be well considered. Introduction The caseload of critically ill patients at a DGH is usually smaller compared to tertiary hospitals. There are some concerns that modern centralisation of services may deskill clinicians at DGHs. Technology Enhanced Learning has an important role to play in improving training. We aimed to analyse professionals' experience, their role and confidence in performing resuscitation and also their opinion about simulation training. Method We conducted a survey at Ysbyty Gwynedd to determine experience of medical and nursing colleagues in managing critically ill children and neonates over last 6 months. A questionnaire asking various aspects of resuscitation was sent out to nursing colleagues and paediatric doctors working at all levels. Of the 50 distributed questionnaires, 40 were completed and returned to us. Results While only 30% had exposure to resuscitation more than twice over preceding 6 months period, approximately 35% had once or no experience. Those who had exposure more than twice felt confident in performing resuscitation. While only 10% were involved in full cardiopulmonary resuscitation, about 30% were involved in airway and breathing and another 20% in circulation. Over 90% stated that they would like to have regular simulation training at least monthly as they felt it will help in coping with actual resuscitation. Conclusion There is limited data available in literature to determine frequency of managing critically ill children at individual level. This study shows that most health professionals have limited exposure to resuscitation situations at a DGH and nearly all paediatric staff wishes to receive regular simulation training. Background Violent/knife crime remains a significant public health challenge in the UK and Europe. Young people are disproportionately affected. Both physical injury in the short term and long term psychiatric conditions such as ...

What factors are associated with ambulance use for non-emergency problems in children? A systematic mapping review and qualitative synthesis

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Parental factors predicting unnecessary ambulance use for their child with acute illness: A cross‐sectional study

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