Chantal Tan (Netherlands)

Erasmus MC - Sophia Children's Hospital General Pediatrics
I am a medical doctor since February 2019 and I have worked as a junior doctor at Pediatrics for a year. In January 2020 I started my PhD at General Pediatrics in Erasmus MC - Sophia Children's Hospital in Rotterdam, the Netherlands. My PhD is about improving diagnosis and management in children with fever visiting European Emergency Departments.

Presenter of 1 Presentation

 Conference Calendar

WHICH LOW URGENT TRIAGED FEBRILE CHILDREN CAN BE REFERRED TO A FAST TRACK UNIT? A EUROPEAN MULTICENTRE OBSERVATIONAL STUDY (ID 436)

Session Name
2505 - PARALLEL SYMPOSIUM 11: MANAGING “TRIVIAL” INFECTIONS (YOUNG ESPID) (ID 101)
Lecture Time
10:01 - 10:08
Room
Hall 03
Presenter

Abstract

Background

The number of paediatric patients visiting the Emergency Department (ED) with non-urgent problems is increasing, which contributes to poor patient flow and ED crowding. Implementation of a fast track can address this problem. We aimed to identify which low urgent triaged children are suitable for a fast track.

Methods

This study is part of the MOFICHE study (Management and Outcome of Febrile children in Europe), an observational study including routine data of febrile children (0-18 years) attending European EDs. Children triaged as low urgent by the Manchester Triage System in nine EDs were included. Children are suitable for a fast track, defined as a lower level of care, if they have minimal resource use and are discharged home. Multivariable logistic regression analyses regarding presenting symptom and management (blood tests, imaging and admission) were performed. Covariates included patient characteristics, referral, previous medical care or antibiotic use, visit hours and ED. Presenting symptoms were categorized into: neurological, (n=234) respiratory (n=8376), gastrointestinal (n=1943) and others (n=3430, reference category).

Results

We included 13,983 children (median age 2.7, IQR 1.3-5.2). The majority was self-referred (68%), had respiratory symptoms (60%) and 31% received antibiotics. The neurological group underwent imaging more often (aOR 1.8, 95%CI 1.1-2.9) and were admitted more frequently (aOR 1.9, 95%CI 1.4-2.6). The respiratory group had less blood tests performed (aOR 0.6, 95%CI 0.6-0.7), more imaging (aOR 1.8, 95%CI 1.6-2.0) and were less frequently admitted (aOR 0.6, 95%CI 0.5-0.7). The gastro-intestinal group had more blood tests performed (aOR 1.2, 95%CI 1.1-1.4) and were admitted more frequently (aOR 1.4, 95%CI 1.2-1.6).

Conclusions

Our study shows that children with respiratory symptoms are most suitable for a fast track, in contrast to the neurological group who underwent more extensive management.

Clinical Trial Registration

This study is not a Clinical Trial.

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