P Richier1, X Gocko2, O Mory3, B Trombert-Paviot4, H Patural5. 1. Pôle mère-enfants, service de réanimation pédiatrique et néonatale, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne, France. 2. Collège stéphanois des généralistes enseignants, faculté Jacques Lisfranc-de-Saint-Étienne, 42023 Saint-Étienne cedex 2, France. 3. Pôle mère-enfants, service d'urgences médico-chirurgicales pédiatriques, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne, France. 4. Département de santé publique, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne, France. 5. Pôle mère-enfants, service de réanimation pédiatrique et néonatale, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne, France. Electronic address: hugues.patural@chu-st-etienne.fr.
Abstract
BACKGROUND: The number of visits to the pediatric emergency services has increased in the past 20 years in France and around the world, especially for neonates (under 28 days of age). OBJECTIVES: Determine for neonates the reasons requiring medical consultation in the emergency pediatric unit of Saint-Etienne University Hospital (France) and isolate the proportion of "non-urgent" preventable consultations that could be managed outside of emergency units. METHOD: Epidemiological, retrospective study on computerized data on neonates who were referred to the pediatric emergency unit of the Saint-Étienne University Hospital from 1 January to 31 December 2011. Four composite criteria "child not addressed by a healthcare professional; severity score G1, G2, G3 based on an internal scale; no further review undertaken; and return home" were used to define "non-urgent" consultations. RESULTS: A total of 419 infants were included in the study. The leading reasons for consultations were crying (14.1%), vomiting (11.9%), chest tightness (10.7%), fever (8.1%), and diarrhea (7%). The main diagnoses were acute nasopharyngitis (11.5%), gastroesophageal reflux (10%), colic (8.1%), and excessive parental anxiety (7.6%). The percentage of "non-urgent" consultations was 52.4%. CONCLUSIONS: Final diagnoses are quite similar to the reasons for consultation. The baby's unexplained crying and the inexperience of young parents resulted in an irrational anxiety. This study highlights the need for parental support at home after discharge from the maternity ward and the use of large-scale educational initiatives.
BACKGROUND: The number of visits to the pediatric emergency services has increased in the past 20 years in France and around the world, especially for neonates (under 28 days of age). OBJECTIVES: Determine for neonates the reasons requiring medical consultation in the emergency pediatric unit of Saint-Etienne University Hospital (France) and isolate the proportion of "non-urgent" preventable consultations that could be managed outside of emergency units. METHOD: Epidemiological, retrospective study on computerized data on neonates who were referred to the pediatric emergency unit of the Saint-Étienne University Hospital from 1 January to 31 December 2011. Four composite criteria "child not addressed by a healthcare professional; severity score G1, G2, G3 based on an internal scale; no further review undertaken; and return home" were used to define "non-urgent" consultations. RESULTS: A total of 419 infants were included in the study. The leading reasons for consultations were crying (14.1%), vomiting (11.9%), chest tightness (10.7%), fever (8.1%), and diarrhea (7%). The main diagnoses were acute nasopharyngitis (11.5%), gastroesophageal reflux (10%), colic (8.1%), and excessive parental anxiety (7.6%). The percentage of "non-urgent" consultations was 52.4%. CONCLUSIONS: Final diagnoses are quite similar to the reasons for consultation. The baby's unexplained crying and the inexperience of young parents resulted in an irrational anxiety. This study highlights the need for parental support at home after discharge from the maternity ward and the use of large-scale educational initiatives.
Authors: Antoine Tran; Anne-Laure Hérissé; Marion Isoardo; Petri Valo; Anne-Marie Maillotte; Hervé Haas; Dominique Donzeau; Emma Freyssinet; Christian Pradier; Stéphanie Gentile Journal: BMJ Open Date: 2022-01-06 Impact factor: 2.692