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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.    

POPS  0  

POPS  >0  

Total  

Presented   1084  (37.5%)   1806  (62.5%)  

2890  

Admiaed  

835  

Age  (mean)  

137  (16.4%)   698  (83.6%)   4.36  

3.91  

4.08  

No  Ix  or  Tx  

614  (54.0%)   521  (45.9%)  

1136  

Ambulance   Arrival  

40  (26.3%)  

152  

112  (73.7%)  

Dr. Damian Roland dr98@le.ac.uk 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    


POPS RCPCH Conference poster 2013