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Efficiency of Using Pediatrics Emergency Services and Triage Evaluation

El Desoky, Sherif, MRCPCH, MD*; Mashat, Suleiman, MBChB*; Bana, Suliman, MBChB*; Alama, Mohamed, MBChB*; Dhabab, Nawaf, MBChB*; Malibari, Ghassan M., MBChB*; Halwani, Manal, MBChB, CABP; Albanna, Amr S., MD, MSc; Kari, Jameela A., FRCP, MD

doi: 10.1097/PEC.0000000000000754
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Objective The aim of the study was to evaluate the pediatric emergency department (PED) in a main teaching hospital.

Methods Retrospective review of all children presented to PED at King Abdulaziz University Hospital from September to November 2014 was performed. We classified priority into the following 5 stages: 1, need resuscitation; 2, emergent; 3, urgent; 4, less urgent; and 5, nonurgent.

Results A total of 2567 children (58.9% boys) attended PED for 3 months. Toddler age group was the highest. Respiratory complaints were the commonest (36%), followed by gastrointestinal complaints (20%). The majority were classified as priority 3 (52.3%) and priority 4 (30.7%). The admission rate was 12.3% and the mean (range) length of stay (LOS) was 5.85 (0.2-25) hours. Saudi nationals were less likely to wait for 5 hours or longer, less likely to be admitted, but more likely to leave PED without being evaluated. There was a negative correlation between higher priorities and time from triage to PED. There was a positive correlation between the higher priorities and LOS.

Conclusions Most children who were seen in PED were priority 3 and therefore needed to be seen. However, a considerable percentage of priority 4 and 5 could have been seen in ambulatory clinics. Most lower priorities were Saudi nationals who were most likely to leave without being seen. Prolonged LOS, overcrowding, and high percentage of admission are the main challenges

From the *Department of Pediatrics and

Emergency Department, King Abdulaziz University Hospital;

King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences; and

§Pediatric Nephrology Center of Excellence, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.

Disclosure: The authors declare no conflict of interest.

Reprints: Jameela Abdulaziz Kari, MD, FRCP, FRCPCH, King Abdulaziz University, Pediatric Nephrology Center of Excellence and Pediatrics Department, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia (e-mail: jkari@doctors.org.uk; jkari@kau.edu.sa).

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