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Journal of General and Emergency Medicine

JGEM

Aabstract

Research Article

Spectrum of Paediatric Emergency at a Tertiary Care Public Hospital in Northern India: Application of WHO-ETAT Triage Guidelines and Predictors of 24 hour Mortality

Ritu Priya Singh, Sciddhartha Koonwar, Sanjeev Kumar Verma and Rashmi Kumar

Correspondence Address :

Rashmi Kumar
Department of Paediatrics, King George's Medical University
India
Tel: 91-9415408777
Email: rashmik2005@gmail.com

Received on: February 22, 2017 , Accepted on: March 15, 2017, Published on: March 22, 2017

Citation: Ritu Priya Singh, Siddhartha Koonwar, Sanjeev Kumar Verma, Rashmi Kumar (2017). Spectrum of Pediatric Emergency at a Tertiary Care Public Hospital in Northern India: Application of WHO-ETAT Triage Guidelines and Predictors of 24 hour Mortality

Copyright: 2017 Rashmi Kumar, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
Spectrum of paediatric emergencies - both types and severity are scarcely reported from India and there is little literature on factors associated with early mortality.
Methods: Consecutive patients presenting to the pediatric emergency in one 24 hour period every week for 40 weeks were enrolled for study.  Record was made of: i) Demographic details ii) Chief complaints and main system involved iii) Presence of variables in WHO ETAT system. Standard definitions for variables were used. Four other variables were also recorded. Association between WHO ETAT and additional variables and mortality within 24 hours was looked for by univariate and logistic regression analysis using standard methods. 
Results: Of total 1014 patients enrolled (mean age 45 (44.6) months; 61% males), the commonest illnesses were respiratory (29.8%), gastro-intestinal/hepatic (16.3%) and neuroinfectious (15.6%). A fourth of patients fell into Level 1 or 2 and 47.1% fell into level 3 of WHO ETAT. Presence of shock, Glasgow coma score (GCS) <=8, severe respiratory distress, SpO2 < 90, continuously restless, irritable or lethargic and severe pallor were significantly associated with mortality within 24 hours with p < 0.05. On logistic regression analysis, shock, GCS <= 8, SpO2 < 90 and continuously restless, irritable or lethargic remained in the final model.
Conclusion: Respiratory illnesses, gastrointestinal/ hepatic and neuroinfectious disorders constituted the commonest illnesses seen. Apart from shock and low Glasgow Coma score (<8), SPO2 < 90 and continuously restless, irritable or lethargic predicted mortality at 24 hours and could be used to possibly improve the triage system.
Keywords: Pediatric Emergency, WHO-ETAT, Triage, Mortality at 24 hours, Spectrum

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