Background: The emergency department (ED) is an essential component of the medical service offered in any hospital. Yet, the published information about patients profile and utilization of emergency services in both developing and developed countries is scarce. Visits caused by non-serious diseases remain a burden on the emergency department, preventing efficient and effective use of health services and compromising quality.
Aim of work: This study aimed to characterize the profile of patients visiting the emergency service in EL-Behera hospitals, Damanhour Teaching hospital, Central Abo Hommos hospital and General Kafr El-Dawar hospital, describing the epidemiology of patient presentations and outcome in the emergency department.
Patient and methods: This is a cross sectional study reporting the profile of patients visiting the ED for 3 months from January to March, 2019. The emergency departments served children up to the age of 18 years. Patients are first examined by a junior physician on a 24 hours basis. The emergency department offered diagnostic services in the form of basic laboratory tests and imaging as well as brief therapeutic measures. Our data were collected from the emergency department sheet initiated by the first examiner and completed by the emergency department senior. Forms were first checked for adequacy and completeness. The data included the following:
• Demographic characteristics: age / sex and season.
• Clinical history: symptoms / diagnosis and outcome within the first 24hours of presentation.
• Patients with previously diagnosed chronic conditions were noted.
• The outcome including discharge from the emergency department whether discharges on treatment or follow up, referral, hospitals admission, or mortality also is noted.
Our cases were collected by visiting the ED for 2 hours at the morning, 2 hours at the evening and 2 hours at the night. Every visit was once per week for 3 months in the 3 study hospitals. During the time of the visit, the investigator was able to examine the majority of children coming for health service.
Results: The total number of registered ED visits during the study period (3months) at El-Behera hospitals (Damanhour Teaching hospital, Central Abo Hommos hospital and General Kafr El-Dawar hospital) was 130500 patients, the number of registered pediatric ED visits at this period was 29340 patients (22.5%).The sample of our study represented 600 patients by collecting random sample through regular visits to ED. Infants (1month-1year) represented the largest age group (52.5%) and boys represented the majority of cases (51.5%). The main presentation was cough (25%) and respiratory distress (21%), followed by fever (15.5%), diarrhea (11%), wheezy chest (11.5%) and then convulsion (4%). Long term illnesses were predominantly bronchial asthma(9%),hemolytic anemia(1%),congenital heart disease(0.5%),down syndrome(0.5%) and failure to thrive(0.5%). The overall mortality rate was zero.
Conclusion: Infants younger than one year are the largest group attending ED 315(52.5%). The respiratory emergencies are the main cause of attending ED 390(65%). Rural attendees are more than urban 375(62.5%) vs 225(37.5%). Chronic disorder is one of causes attending ED. The rate of hospitalization is low 72(12%). The case fatality rate is zero percent. The most patients attending ED at the evening were 285 (47.5%).