CORRELATION BETWEEN THE INITIAL DIAGNOSIS IN PEDIATRIC MEDICAL EMERGENCIES DEPARTMENT AND THE FINAL DIAGNOSIS CONFIRMED AT THE LEVEL OF PEDIATRIC HOSPITAL DEPARTMENT

Abstract

Introduction: Medical practice in the emergencies is particularly prone to diagnostic errors resulting not only in a potential delay risk of an effective treatment in therapeutic urgent cases, but also in the risk of subscribing unnecessary or even harmful treatments.
 Objective: The purpose of this study is to analyze the correlation between the initial diagnosis identified at the level of the emergencies department and the diagnosis being confirmed at the hospital medical department, with the aim of elaborating an action plan for a clinical approach to reduce diagnostic errors in the emergency department.
 Materials and methods: This study is a prospective and descriptive analytical one that builds on a compilation of the diagnostic hypotheses of patients who are admitted and hospitalized on the day of their admission to the pediatric emergencies department of the pediatric hospital Rabat. Patients with purely clinical confirmatory diagnoses as well as patients having a previously confirmed diagnosis were excluded from this study. The diagnostic hypotheses are discussed in the daily morning meeting of the department in order to discuss and retain the most probable initial diagnosis. The correlation is checked by following up on the file of the patient admitted in the pediatric department.
 Results: The study covered 100 initial diagnoses in the pediatric emergency department. The correlation was positive for 95 diagnoses (95% of the cases). There was a 5% negative correlation as follows: convulsion (1% of the cases), infectious endocarditis (1% of the cases), congenital heart disease (1% of the cases), pyelonephritis (1% of the cases), acid-ketotic decompensation (1% of the cases).
 Conclusion: It is crucial to have a structured and chronological questionnaire starting from the first abnormal symptom, and declining the main diagnostic hypotheses favoring therapeutic emergencies.