Characteristics and interventions in critical patients in spanish paediatric emergency departments: a prospective multicenter study.

Objective: To describe the clinical characteristics and interventions performed on critically ill patients admitted to pediatric emergency departments (PED) in Spain.

Methods: Study based on a prospective multicenter registry of 19 PED included in the critical patient working group of the Spanish Society of Pediatric Emergencies. We included critical patients under 18 years of age admitted to those PEDs on the 4th, 14th, and 24th of each month between February 2020 and January 2022 (2 years). Critical patient was defined as one who met at least one of the following criteria: admission to a pediatric intensive care unit, stabilization procedures of the airway or circulatory system in the PED.

Results: During the study period, 116,138 episodes were registered in the PEDs, and 255 (0.2%) were critically ill patients (median age 15 months; medical conditions 232, 91.0%). Of these, 145 (56.9%) required airway stabilization and 19 (7.5%) circulatory procedures. Eighty-four (32.9%) received prehospital care, 9 requiring airway stabilization and 6 circulatory procedures (5 cardiac massage). In the PEDs, 233 patients (91.4%) required interventions, of which 15 (5.9%) were airway stabilization, 1 (0.4%) circulatory and 8 (3.1%) both. Ten patients died (3.9%).

Conclusions: Critically ill patients are infrequent in Spanish PEDs. The high rate of procedures performed emphasizes the importance of adequate training of healthcare pre-hospital and in-hospital professionals.