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Managing Families With Multiple Children in the ED

Managing Families With Multiple Children in the ED

It is not uncommon for families to bring multiple children to the ED for evaluation at a single visit. These children often require fewer ED resources than patients presenting individually. “Non-urgent visits can become a significant obstacle to throughput and optimal use of the ED,” says Ilene Claudius, MD. These patients tend to have lower triage acuity and low hospital admission rates when compared with the general patient population. Assessing Urgent Care Needs In the Western Journal of Emergency Medicine, Dr. Claudius and colleagues had a study published that examined the actual need for urgent interventions in children of families registering multiple patients at once and compared these findings with families that registered single patients. Using a retrospective chart review, the investigators considered five interventions to be critical (admission, subspecialty consultation, performance of procedures, IV fluid administration, and observation for more than 6 hours). A sample of 83 patients from 41 families that registered multiple children was compared with 248 singleton controls. Only 4.8% of patients from families registering multiple children required critical ED interventions, compared with a 32.5% rate observed for families registering just one child. “While many children required medical care, our study showed that the vast majority of care that was required by families registering multiple children could have been rendered in a primary care setting,” says Dr. Claudius. “Families presenting with multiple children as patients mainly fell into a non-urgent category in terms of need for ED resource use.” A Continuing Problem The concept of patients using EDs as primary care has been well established in published research. “In many cases, parents may realize that...
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