Common Presenting Problems for Young People Attending the Emergency Department

Objective. To determine the common presenting problems for young people attending the emergency department. Design. A retrospective review of electronic patient records of all young people between the ages of 13 and 17 who attended a UK University Hospital ED between 07/02/2007 and 06/02/2008 ( ). Results. All emergency department attendances for young people over a one-year period were studied in order to determine the common presenting problems. There were a total of 10455 attendances by 8303 young people. The presenting problem in 7505 (71.8%) was classified as injury. Of the remainder the commonest presenting problems reported for young people were abdominal pain (480, 16.3%), self-harm (314, 10.6%), fits, faints and funny turns (308, 10.4%), breathing difficulty (213, 7.2%), and intoxication (178, 6.0%). Ten presenting problems accounted for 72% of noninjury related attendances. Conclusions. Clinical guidelines and pathways developed for young people attending the emergency department should target the commonest presenting problems. In our cohort ten presenting problems account for almost three-quarters of all noninjury attendances for young people. The presenting problems are different to those described in younger children in previous studies. These results will inform the development of clinical pathways in order to improve emergency care. 1. Introduction Adolescence is commonly regarded as a healthy period of life and consequently there is a paucity of data regarding the health of young people and how they access healthcare [1]. Paradoxically young people are especially vulnerable to health problems related to injury, suicide, pregnancy, substance misuse, and long term conditions. Young people represent a significant proportion of the population and this proportion is increasing, especially in the ethnic minority groups [2, 3]. The number of emergency admissions in older adolescents has risen steadily since the mid-1990s whilst admissions for younger children have fallen in recent years [3]. There is limited published English data on the reasons for young people being admitted to hospital, the reasons they attend hospital services, or healthcare utilisation in general [1]. Armon et al. carried out the first study in the UK looking at the common paediatric presentations to the emergency department. They identified that high quality data regarding paediatric attendances is required in order to plan services [4]. Their data informed the development of a number of presenting problem based guidelines, which were derived from best evidence, and have