Adhérence parentale à un service d’urgences après orientation téléphonique

Abstract

Background: The Centrale Téléphonique des Médecins de Garde (CTMG) is a 24-hour service call centre which specializes in evaluating, sorting and orientating children and adults with urgent and nonurgent medical problems. Parents’ calls are regulated by nurses. Little is known about parental adherence to referral following triage recommendations. Objectives: To determine parents’ adherence with referral to the emergency department of the Hôpital de l’Enfance de Lausanne (HEL) after being referred by the nurses of the CTMG. Design / Methods: This was a prospective and observational study. From November 4 to December 4 2019, pediatric calls (<15 years old) with urgent orientation (<2 hours) were selected. Non-urgent and life-threatening emergencies were excluded. Children orientation was then verified in the HEL emergency department, as well as their triage score (Australasian Triage Scale, ATS) and their final outcome (discharged home or hospitalised). Results: Parental adherence to the orientation is 76% (343/451). 302/343 (88%) arrived in the emergency department within 2 hours. 169/343 (49%) were given an ATS score of 2, 3 or 4 upon arrival. 35/343 (10%) were hospitalised or needed further investigations. The 3 major call complaints were respiratory (107/451, 24%), gastrointestinal (89/451, 20%) and trauma (78/451, 17%). Median age was 2 years old. 298/451 (66%) children who were referred by CTMG were up to 3 years old or under. Conclusion: Parental adherence to the emergency department is satisfying. This result matches with literature data (63- 83%). Also, the time period of arrival in the emergency department was respected. No cases were under-evaluated by the call centre