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Paediatric Admissions

6

Emergency Department

articles not available in full text online; through the  Universities of Alberta or Calgary;  

or through the library holdings in the Calgary Health Region

In total, 27 potentially relevant publications were selected for analysis and of those a final six were selected for an in depth review. In general, the SEARCH participant found that there was very little relevant data was published. Many of the articles not chosen examined various different models in but populations that were too divergent to the target population of the project.  During the analysis of the final six articles, common themes extracted and potential for application across populations sought. The analysis of the six articles follows.

Results of the Review of the Literature

The first article that was reviewed discussed the need for regionalization of paediatric services and was published in the journal Pediatric Emergency Care in 2001 (Athey et al., 2001).  This article discussed a project in which a survey was administered to 91 hospitals across the United States of America who have 24 hour Emergency Care provided in their facilities in order to estimate the distribution of paediatric services available at theses hospitals.  This was a self reporting survey and there was no confirmation of the results by direct visitation of the surveyed sites.  The results showed that the majority of the hospitals surveyed did not have separate paediatric departments/wards, many did not admit the children to their hospital from the Emergency Departments and few had paediatric Emergency physicians.  In these hospitals, emergency and intensive care were provided by Adult specialists and few of the hospitals had paediatric protocols. The results suggested that the emergent and urgent care of paediatric patients was not well integrated in the system at the time. The authors pointed out that the survey did not include outcome data for the patients seen at these hospitals.  They did reinforce their beliefs that children should be cared for in hospitals with paediatric specialists, appropriate equipment and specific protocols. They argue that centers with these specifications have better outcomes due to greater exposure to the population, more focused education and are overall better equipped to provide urgent, emergent and in-patient care.

The next three articles reviewed discussed the specific needs for paediatric Emergency Departments. The first was by Canadian and was authored by McGillivray et al. and was published in 2001. The second article was published in the United States and was the guidelines for the care of children in the

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