Spring Meeting Ulster Paediatric Society 9th February 2012: Education Centre, Royal Group of Hospitals, Belfast

Aim: To examine the medical and social factors involved in the presentation of neonates in the first 14 days of life to a paediatric emergency department (PED) and outcome following attendance. Methods: Retrospective study of all attendances of neonates in the first 14 days of life to a PED during two separate three month periods in summer and winter 2010-2011. Data were collected from PED computer system and compared with computerized medical records from maternity and paediatric inpatient systems. (PAS) Results: There were 235 attendances during 6 months of study. The majority of these attendances occurred " out of hours " (80%). Parent self-referrals (62%), GP referrals (20%) and referrals from midwives (12%) accounted for 95% of all attendances. The most frequent presenting problems were feeding difficulties (37%) and breathing difficulties (18%). The most common final diagnoses on discharge from ED were feeding difficulties (35%), respiratory tract infections (12%) and jaundice (11%); in 14%, no abnormality was found. The admission rate to hospital was 26%. Seasonal variation was noted; Winter (23%), Summer (30%). One in three babies admitted were discharged within 24 hours; one in ten babies were admitted for 7 days or longer. Conclusions: Attendance of neonates in the first 14 days of life to a PED is common, especially out of hours. The majority of neonates have minor illnesses. A number of neonates, however, have significant morbidity requiring prolonged admission. Enhanced community services for neonates are required, particularly out of hours, in order to reduce emergency attendances and subsequent brief admissions to hospital. Adequate signposting of services, given the high proportion of parental referrals, is important. Given the prevalence of feeding difficulties presenting at this age, additional resources would be of benefit. Background: The GMC requires that all medical students are competent in drug prescription. Despite specific teaching on drug prescribing and administration within undergraduate curricula drug errors remain common. One third of paediatric medication errors involve an incorrect calculation.