Objectives: Emergency departments (EDs) varied in their preparedness to provide pediatric emergency care, with mortality rates being higher when EDs were unprepared. Guidelines are available to aid EDs in their preparedness. We aimed to determine the preparedness of EDs in our healthcare cluster using the guidelines from the Royal College of Pediatrics and Child Health (RCPCH) and International Federation for Emergency Medicine (IFEM) as references for audit.
Methods: This was a cross-sectional study involving a pediatric ED and 3 general EDs within a healthcare cluster. A survey was completed by a pediatric representative at each ED who assessed his/her own ED's effort against each recommended standard with reference to calendar year of 2018. The availability of pediatric equipment, supplies, and medications was checked against the items recommended list by the IFEM.
Results: The response rate was 100%. The proportion of agreement with reference standards was lower for general EDs (RCPCH: 11.4%-70.0% and IFEM: 39.6%-84.0%) than pediatric ED (RCPCH: 85.7% and IFEM: 91.7%). Unmet standards were predominantly in the categories of management of pediatric patients with complex medical needs, management of pediatric death, adolescents, mental health and substance misuse, protection and safeguarding of pediatric patients, as well as advanced training and research. The proportion of available equipment, supplies, and medications was also lower for general EDs (77.2%-82.0%) than pediatric ED (89.4%).
Conclusions: The standards of pediatric emergency care were met to different extents in the healthcare cluster. Using available references, EDs should identify lapses unique to their own settings to improve the delivery of pediatric emergency care.