Pediatric emergency admission practices in French hospitals

Background. - Recently, several measures were implemented to restructure the frame-work of hospital emergency admissions. However, these measures concern primarily adults. Pediatricians made on their own several proposals to improve admission of children. They felt that these proposals should be supported by statistical numbers. Several investigations were then conducted. Population and methods. - The authors report the results of two investigations conducted in January 1994 and January 1995 in all French hospitals admitting children in emergency. Results. - The results shows that 60% of the purposes for consultations are of a general medical nature which does not require emergency assistance. The emergency cases were estimated genuine in only 10% of all incoming patients while all other cases were benign or treated merely as simple outpatient consultations. Accidental pathology represented 30% of all cases. More than half of the children were less than five years old. in most cases, a pediatrician was readily available night and day in all University hospitals which was, unfortunately, not the case in most general hospitals where the number of pediatricians was insufficient to assure night duties. Conclusion. - The result of these investigations does not provide an exhaustive picture of the overall pediatric emergencies. It demonstrates, however, the quantitative importance of pediatric emergencies while emphasizing on their differentiation in qualifications and specialization of the practicians and nurses in charge of incoming patients from one hospital to another. It demonstrates thar serious efforts need to be made so that the child may be readily directed to an hospital emergency center with appropriate medical and paramedical personnel, a situation which, unfortunately, does nor always prevail at present.