Imperial College London
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DrJethroHerberg

Faculty of Medicine, Department of Infectious Disease

Clinical Reader in Paediatric Infectious Disease
 
 
 
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j.herberg

 
 
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Location

 

231Wright Fleming WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Tan:2024:10.1136/emermed-2023-213375,
author = {Tan, CD and Vermont, CL and Zachariasse, JM and von, Both U and Carrol, ED and Eleftheriou, I and Emonts, M and van, der Flier M and Herberg, J and Kohlmaier, B and Levin, M and Lim, E and Maconochie, IK and Martinon-Torres, F and Nijman, RG and Pokorn, M and Rivero-Calle, I and Rudzte, A and Tsolia, M and Zenz, W and Zavadska, D and Moll, HA and PERFORM, consortium Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union},
doi = {10.1136/emermed-2023-213375},
journal = {Emerg Med J},
pages = {236--241},
title = {Which low urgent triaged febrile children are suitable for a fast track? An observational European study.},
url = {http://dx.doi.org/10.1136/emermed-2023-213375},
volume = {41},
year = {2024}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: The number of paediatric patients visiting the ED with non-urgent problems is increasing, leading to poor patient flow and ED crowding. Fast track aims to improve the efficiency of evaluation and discharge of low acuity patients. We aimed to identify which febrile children are suitable for a fast track based on presenting symptoms and management. METHODS: This study is part of the Management and Outcome of Fever in children in Europe study, which is an observational study including routine data of febrile children <18 years attending 12 European EDs. We included febrile, low urgent children (those assigned a triage acuity of either 'standard' or 'non-urgent' using the Manchester Triage System) and defined children as suitable for fast track when they have minimal resource use and are discharged home. Presenting symptoms consisted of neurological (n=237), respiratory (n=8476), gastrointestinal (n=1953) and others (n=3473, reference group). Multivariable logistic regression analyses regarding presenting symptoms and management (laboratory blood testing, imaging and admission) were performed with adjustment for covariates: patient characteristics, referral status, previous medical care, previous antibiotic use, visiting hours and ED setting. RESULTS: We included 14 139 children with a median age of 2.7 years (IQR 1.3-5.2). The majority had respiratory symptoms (60%), viral infections (50%) and consisted of self-referrals (69%). The neurological group received imaging more often (adjusted OR (aOR) 1.8, 95% CI 1.1 to 2.9) and were admitted more frequently (aOR 1.9, 95% CI 1.4 to 2.7). The respiratory group had fewer laboratory blood tests performed (aOR 0.6, 95% CI 0.5 to 0.7), were less frequently admitted (aOR 0.6, 95% CI 0.5 to 0.7), but received imaging more often (aOR 1.8, 95% CI 1.6 to 2.0). Lastly, the gastrointestinal group had more laboratory blood tests performed (aOR 1.2. 95% CI 1.1 to 1.4) and were admitted more frequently (aOR 1.4, 95%
AU  - Tan,CD
AU  - Vermont,CL
AU  - Zachariasse,JM
AU  - von,Both U
AU  - Carrol,ED
AU  - Eleftheriou,I
AU  - Emonts,M
AU  - van,der Flier M
AU  - Herberg,J
AU  - Kohlmaier,B
AU  - Levin,M
AU  - Lim,E
AU  - Maconochie,IK
AU  - Martinon-Torres,F
AU  - Nijman,RG
AU  - Pokorn,M
AU  - Rivero-Calle,I
AU  - Rudzte,A
AU  - Tsolia,M
AU  - Zenz,W
AU  - Zavadska,D
AU  - Moll,HA
AU  - PERFORM,consortium Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union
DO  - 10.1136/emermed-2023-213375
EP  - 241
PY  - 2024///
SP  - 236
TI  - Which low urgent triaged febrile children are suitable for a fast track? An observational European study.
T2  - Emerg Med J
UR  - http://dx.doi.org/10.1136/emermed-2023-213375
UR  - https://www.ncbi.nlm.nih.gov/pubmed/38238066
VL  - 41
ER  -
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