Newborn consultations in a pediatric emergency department
DOI:
https://doi.org/10.29193/RMU.37.4.7Keywords:
NEWBORN, EMERGENCY MEDICAL SERVICES, PEDIATRICSAbstract
Introduction: the number of newborn presentations to the Pediatric Emergency Department is gradually increasing. However, not all cases are caused by significant risks.
Objective: to describe the characteristics of newborn presentations to the pedriatric emergency department of a comprehensive health care provider between January 1 and December 31, 2018.
Method: descriptive study by analysing medical records and telephone interviews to mothers. Newborn, maternal and consultation variables were analysed.
Results: 237 presentations were recorded, 209 of which corresponded to newborns, male neonates 53%, average age was 16 days. Diagnostics upon discharge were classified into three categories: 1) consultations associated to childcare (29%), 2) physiological processes (22%) and severe conditions (49%). Hospitalization rate was 27%. 64 newborns were hospitalized: 2 of them belonging to group 1 (low weight gain); 6 to group 2 (jaundice); 56 to group 3. Average hospital stay was 3 days (range 1-14). No deaths were recorded.
Conclusions: most consultations were caused by non-severe conditions which were potentially avoidable. However, given the high vulnerability of this group of patients, emergency pediatricians must carefully assess these infants. It may be possible that the frequency of these consultations drops by making access to the first level of care easier, and by providing parents with more complete information. Learning about the health problems that are typical of newborns and the main concerns of parents constitutes an important input for the implementation of improvement strategies and to optimize the use of resources.
References
2) Zimmer K, Walker A, Minkovitz C. Epidemiology of pediatric emergency department use at an urban medical center. Pediatr Emerg Care 2005; 21(2):84-9.
3) Fernández Ruiz C, Trenchs Sainz de la Naza V, Curcoy Barcenilla A, Lasuen del Olmo N, Luaces Cubells C. Asistencia a neonatos en el servicio de urgencia de un hospital terciario. An Pediatr (Barc) 2006; 65(2):123-8.
4) O’Donnell H, Colman G, Trachtman R, Velazco N, Racine A. Impact of newborn follow-up visit timing on subsequent ED visits and hospital readmissions: an instrumental variable analysis. Acad Pediatr 2014; 14(1):84-91.
5) Kennedy T, Purcell L, LeBlanc J, Jangaard K. Emergency department use by infants less than 14 days of age. Pediatr Emerg Care 2004; 20(7):437-42.
6) Millar K, Gloor J, Wellington N, Joubert G. Early neonatal presentations to the pediatric emergency department. Pediatr Emerg Care 2000; 16(3):145-50.
7) Flanagan C, Stewart M. Factors associated with early neonatal attendance to a paediatric emergency department. Arch Dis Child 2014; 99(3):239-43.
8) Droz N, Chaleard J, Laurent M, Mandelbrot L, Cojocaru B. Les consultations des nouveau-nés aux urgences pédiatriques. Soins Pediatr Pueric 2018; 39(303):32-7.
9) Richier P, Gocko X, Mory O, Trombert-Paviot B, Patural H. Étude épidémiologique des consultations précoces de nouveau-nés aux services d’accueil des urgences pédiatriques. Arch Pediatr 2015; 22(2):135-40.
10) Cabrera S, Iglesias J, Bernárdez I, Marín M, Hidalgo M, Braverman A. Principales causas de visita de neonatos al servicio de urgencias de un hospital privado. An Med (Mex) 2016; 61(4):251-5. Disponible en: https://www.medigraphic.com/pdfs/abc/bc-2016/bc164c.pdf. [Consulta: 13 noviembre 2020].
11) Batu E, Yeni S, Teksam O. The factors affecting neonatal presentations to the pediatric emergency department. J Emerg Med 2015; 48(5):542-7.
12) Pérez Solís D, Pardo R, Fernández A, Ibáñez A, Prieto S, Fanjul J. Atención a neonatos en una unidad de urgencias pediátricas. An Pediatr (Barc) 2003; 59(1):54-8.
13) Mezquita M, Pavlicich V, Luaces C. El sistema español de triage en la evaluación de los neonatos en las urgencias pediátricas. Rev Chil Pediatr 2017; 88(1):107-12.
14) Assandri E, Ferreira M, Bello O, de Leonardis D. Hospitalización neonatal desde el servicio de urgencias en un centro hospitalario de Uruguay. An Pediatr (Barc) 2005; 63(5):413-7.
15) Boyadjian S, Notejane M, Assandri E, Pujadas M, Pírez C. Bronquiolitis en neonatos. Experiencia de cuatro años en un hospital de referencia nacional. Arch Pediatr Urug 2015; 86(4):265-72.
16) Notejane M, Casuriaga A, Giachetto G. Hospitalizaciones por conjuntivitis neonatal infecciosa en un centro de referencia de Uruguay: características clínicas y evolutivas. Rev Hosp Jua Mex 2019; 86(1):26-32.