Main timetables of pediatric emergencies. Experience at the Lenval hospital in 1999

The purpose of the present study was to determine the main schedules of a visit in a paediatric emergency ward. A prospective survey concerning the main schedules of the children examined in the paediatric emergency ward of the Lenval's hospital in Nice in 1999 was implemented. The study was conducted over a period of 84 days, one week per month, and included 6038 children analysed recording to the following criteria: 1) duration of the waiting; 2) duration of the radiological period; 3) duration of the medical advice and/or treatment period; 4) total time course of the visit. Data were collected in 66.6% of all cases for waiting (n = 4022), 52.1% for medical advice (n = 3149), in 44.1% for radiological time (n = 833 of 1888 children having radiological examination), in 58.1% for the total time course of the visit. Waiting for not severe emergencies was about one time out of three less than five minutes, more than one time out of two less than 15 minutes, and more than three times out of four less than 30 minutes. Mean radiological time course was 20 to 25 minutes. Mean medical advice was 15 minutes, for medical consultations such as surgical ones. Total time course of the visit was less than 30 minutes in 23.1% of all cases, 30 to 60 minutes in 38.5%, one to two hours in 31.3%, two to four hours in 6.8%, and more than four hours in 0.3% of all cases. Mean total time course of the visit was 45 minutes for medical emergencies and 55 minutes for surgical ones. This study shows the main schedules of a visit in a paediatric emergency ward which took care of 26,726 children in 1999. The results of this survey confirmed that waiting before consultation, for not severe emergencies, is sometimes long or very long because of a constant increasing number of patients and their preferential breakdown according to specific periods (weekends, public or school holidays, winter) which are the result of demographic, social and economic changes. At present, the only available possibility to control both phenomena consists in adjusting and adopting medical tools and staffs to crowds and flows. This study also confirms the usefulness for paediatric emergency ward to have a short hospitalization unit.