Introduction
Methods
Study design and population
Data collection
Definitions
Statistical analysis
Results
Population characteristics
n/N (%)a | |
---|---|
General characteristics | |
Male sex | 2451/4557 (53.8%) |
Age in yearsb | 2.4 (1.1–4.7) |
Season | |
- Spring | 1110/4560 (24.3%) |
- Summer | 766/4560 (16.8%) |
- Autumn | 1024/4560 (22.5%) |
- Winter | 1660/4560 (36.4%) |
Way of referral | |
- General practitioner | 395/4524 (8.7%) |
- Self | 3966/4524 (87.7%) |
- Other healthcare professional | 163/4524 (3.6%) |
Triage level | |
- Immediate or very urgent | 197/3850 (5.1%) |
- Urgent | 1042/3850 (27.1%) |
- Standard | 1866/3850 (48.5%) |
- Non-urgent | 745/3850 (19.4%) |
Abnormal vital signs | |
Fever (temperature ≥ 38 °C) | 2403/4435 (54.2%) |
Tachycardiac | 1138/3341 (34.1%) |
Tachypnoeac | 665/2333 (28.5%) |
Hypoxia (oxygen saturation ≤ 94%) | 85/2567 (3.3%) |
Prolonged capillary refill (> 3 s) | 67/4560 (1.5%) |
Disposition | |
- Discharged home | 4035/4559 (88.5%) |
- Observation unit < 24 h | 187/4559 (4.1%) |
- Admitted to ward | 321/4559 (7.0%) |
- Admitted to ICU | 11/4559 (0.2%) |
Hospital | Country (code) | n | Annual PED visits | Type | Setting | Responsible specialist | Triage system | NICE recommendations on measurement of vital signs in use? |
---|---|---|---|---|---|---|---|---|
Aarhus Universitetshospital, Skejby | Denmark (DK) | 24 | 5000 | Academic | Mixed | Paediatrician | Local/national | Yesa |
Hopital Antoine Béclère, Paris | France (FR) | 53 | 25,000 | Academic | Inner city | U | U | Yesa |
Hôpital Mère-Enfant, Nantes | 118 | > 25,000 | Academic | Inner city | Paediatrician | Local/national | ||
Hôpital Necker-Enfants malades, Paris | 285 | 66,000 | Academic | Inner city | PEM specialist | Local/national | ||
Hopital Robert Debre, Paris | 384 | 88,000 | Academic | Inner city | Paediatrician | U | ||
Roger Salengro Hospital, Lille | 86 | 25,000 | Teaching | Inner city | PEM specialist | MTS | ||
Heim Pal Children’s Hospital, Budapest | Hungary (HU) | 111 | 30,000 | Teaching | Mixed | Paediatrician | CTAS | Yesa |
Meyer University Children’s Hospital, Florence | Italy (IT) | 160 | 42,000 | Academic | Inner city | Paediatrician | Local/national | Yesb |
Ospedale dei Bambini, Azienda Ospedaliera Spedali Civili, Brescia | 182 | 36,500 | Academic | Mixed | Paediatrician | Local/national | ||
University Hospital, Padova | 104 | 25,000 | Academic | Inner city | Paediatrician | Local/national | ||
ErasmusMC—Sophia, Rotterdam | The Netherlands (NL) | 60 | 4000 | Academic | Inner city | Paediatrician | MTS | Yesb |
Flevoziekenhuis, Almere | 19 | 5000 | Teaching | Mixed | Paediatrician | MTS | ||
Maasstad Ziekenhuis, Rotterdam | 28 | 3500 | Teaching | Inner city | Paediatrician | MTS | ||
Reinier de Graaf, Delft | 29 | 2643 | Teaching | Mixed | Paediatrician | MTS | ||
Sint Franciscus Ziekenhuis, Rotterdam | 25 | 2700 | Teaching | Inner city | Paediatrician | MTS | ||
Centro Hospitalar de Leiria, Leiria | Portugal (PT) | 201 | 46,000 | Teaching | Mixed | Paediatrician | Local/national | Yesb |
Lisbon Medical Academic Center (Hospital de Santa Maria), Lisboa | 282 | 50,000 | Academic | Inner city | Paediatrician | Local/national | ||
Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra | 215 | 60,000 | Academic | Inner city | Paediatrician | CTAS | ||
Emergency Children’s Hospital, Cluj-Napoca | Romania (RO) | 168 | 9400 | Teaching | Rural | Paediatrician or PEM | ESI | Yesb |
Tirgu Mures Emergency Clinical County Hospital, Tirgu Mures | 114 | 16,000 | Academic | Inner city | Paediatrician | ESI | ||
Cruces University Hospital Bilbao, Basque country | Spain (ES) | 230 | 53,000 | Academic | Inner city | PEM specialist | CTAS | No |
Hospital de Mendaro, Mendaro (Guipúzcua) | 60 | 7160 | Non-teaching | Rural | U | U | ||
Hospital Universitario Rio Hortega, Valladolid | 248 | 24,000 | Teaching | Mixed | PEM specialist | PAT | ||
San Agustín University Hospital, Linares, Jaén | 93 | U | Teaching | Mixed | Paediatrician | U | ||
University Hospital, Geneva | Switzerland (CH) | 230 | 25,500 | Academic | Inner city | PEM specialist | CTAS | Yesa |
Children’s Hospital of Zurich, Zurich | 198 | 37,000 | Academic | Inner city | Emergency physician | ATS | ||
Cukurova University Medical Faculty Balcali Hospital, Adana | Turkey (TK) | 708 | 20,000 | Academic | Mixed | PEM specialist | None | Yesb |
St Mary’s Hospital, London | United Kingdom (UK) | 145 | 27,000 | Academic | Inner city | PEM specialist | MTS | Yesb |
Overall measurement of vital signs and per country
Measurement of vital signs per triage level, age group and diagnosis
Frequency of abnormal findings
Adherence to guideline recommendation
Full chart measured | n/N (%)a | OR (95% CI)b |
---|---|---|
Diagnosis | ||
- Fever without focus | 72/170 (42%) | Reference |
- Other | 53/134 (40%) | 0.94 (0.50–1.77) |
- Urinary tract infection | 37/83 (45%) | 1.19 (0.56–2.54) |
- Enteric | 142/352 (40%) | 1.26 (0.75–2.12) |
- Upper RTI | 922/1856 (50%) | 1.75 (1.10–2.77) |
- Lower RTI | 193/350 (55%) | 3.75 (2.21–6.37) |
- Sepsis–meningitis | 5/11 (46%) | 1.93 (0.49–7.65) |
Triage level | ||
- Non-urgent | 180/526 (34%) | Reference |
- Standard | 368/1117 (33%) | 0.75 (0.54–1.05) |
- Urgent | 358/715 (50%) | 1.36 (0.96–1.95) |
- Immediate or very urgent | 98/163 (60%) | 1.62 (0.95–2.76) |
Crowding of PED | ||
- Usual number of daily visits | 519/1267 (41%) | Reference |
- Less visits than usual | 168/463 (36%) | 0.83 (0.62–1.10) |
- More visits than usual | 296/775 (38%) | 0.98 (0.77–1.24) |
Age groups | ||
- 0 to 3 months | 81/139 (58%) | 1.76 (1.06–2.92) |
- 3 to 12 months | 392/728 (54%) | 1.38 (1.09–1.75) |
- 1 to 5 years | 976/2146 (46%) | Reference |