Too old for a paediatric emergency department? It's complex

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Abstract
Background In Ireland, the paediatric emergency department (PED) is tasked with acute healthcare provision to children and adolescents under 16 years of age. The population > 15 years attending the PED remains undescribed. Aims The objective of the study is to describe the presentations of patients > 15 years to the PED of a national tertiary academic paediatric hospital. Methods A retrospective review of electronic records identifying all patients (> 15 years) who presented from January 2014 to December 2015. Patient demographics, presenting complaint, diagnosis, treatment and disposition were recorded. Results A total of 71,082 patients attended during the study period; of whom, 426 (0.6%) patients were aged 16 to 61 years. Over half were identified as having clearly defined chronic complex conditions. Three hundred and forty-five (89%) patients were known to the hospital paediatric services and under the care of specialist with 131 (34%) patients admitted locally, all of whom had chronic complex conditions (CCC). There was a total of 44 (11%) patients who presented to the PED with de novo issues and had a variety of acute presenting complaints with minor injuries, syncope and chest pain being most common. Conclusion This is the first Irish study demonstrating a significant population (> 15 years) with medical complexity that requires a suite of services in a paediatric hospital which is accessed in an unscheduled manner through an emergency department. We recommend further research to describe paediatric CCC attending Irish emergency and hospital services.

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