Children in the Accident and emergency department

Facilities for children and their families

Between 20 and 30 per cent of attenders at District General Hospital Accident and Emergency A&E departments are children under 16 years old. In England and Wales there are more then two million child attenders at A & E departments annually. There is a disproportionately high number of attenders under five years of age.

It is sometimes considered that because children are small they require a smaller provision of space in hospital buildings than do adults. In fact he opposite is true. Children attending A & E departments are usually accompanied by at least one adult, and often siblings, prams, or pushchairs.

The requirements in Box 1.1 are supported by the Joint statement on children’s A & E attendances produced in 1988 by the British Paediatric association. The British Association of Paediatric Surgeons, and the Gasualty Surgeons Association Now the British Association for Accident and Emergency medicine.

A separate resuscitation area for children is not appropriate for most A& E departments. But equipment and drugs for children should be easily identifiable and available.

Children in the accident and emergency department:

Minimum requirements for children in A & E.

Separate triage and waiting area with play facilities.

Separate treatment area suitable decorated and equipped.

Private room fro distressed parents.

At least one RSCN trained nurse on the staff.

A consultant pediatrician to have responsibility for liaison with the consultant in A & E medicine.

A liaison health visitor to facilitate communication between the department and the community.

Categories of paediatric problems in A & E

Trauma medical surgical Behavioural/ psychiatric problems.

Trauma

Injured children account for the majority of attendances 60-70 per cent. Must will have relatively minor injuries bail a few will have suffered major blunt or more rarely, penetrating injury or severe burns or scalds, or will have boon seriously poisoned.

Accidents are the most common cause of death in children over one year old in the united KINGDOM each year about 700 children die as a result of accidents and about 10000 become permanently disabled. About 20 per cent of children’s admissions to hospital are the result of accidents.