Improving insight into the demography of children presenting with no physiological, behavioural or nursing concern. Dr Damian Roland, Dr. Gareth Lewis, Dr. Fﬁon Davies and the nursing staﬀ in the Leicester Royal Inﬁrmary Children’s Emergency Department
Do you know how many children presenAng to your department have a complete set of observaAons on arrival?
Failure to recognise or over-‐interpret observaAons and assessments leads to missed cases and unnecessary admissions!
How many children do you admit with normal observaAons?
BACKGROUND Although triage systems, such as the MTS, can be used to determine a ‘least sick’ cohort they do not give granular data. We have introduced a bespoke assessment tool within our department, the Paediatric ObservaAon Priority Score and the recent introducAon of an electronic recording system has enabled key physiological and observaAonal informaAon to be recorded prospecAvely and matched with commonly recorded Emergency Department outcomes.
METHODOLGY Ethical and InformaAon Governance Board approval was obtained to record electronically the eight POPS domains. Data was collected between August and December 2012 on all children between the ages of 0-‐15 with no other exclusion criteria. PaAent discharge disposiAon, and number of Emergency Department InformaAon system recorded invesAgaAons (Ix) and treatments (Tx) was merged with the data ﬁle. PaAents presenAng directly to the resuscitaAon room were not included in the data set.
Presented 1084 (37.5%) 1806 (62.5%)
137 (16.4%) 698 (83.6%) 4.36
No Ix or Tx
614 (54.0%) 521 (45.9%)
Dr. Damian Roland firstname.lastname@example.org www.pemla.org
A POPS app is now available for free on the APP store.
POPS is copyright Dr. Damian Roland and Dr. Fion Davies (May 2010) A creaAve commons license is being developed
Conclusion Children with no physiological or observaAonal derangement make up a signiﬁcant proporAon of aaendances at our Emergency Department. This may not be a sustainable health care model