G394(P) Do they listen to my heart? a study of cardiovascular examination in a general paediatric clinic

Abstract

Aim There has been an increase in referrals to paediatric cardiology clinics, at the same time concerns have been raised on the clinical skills related to cardiological examination. This retrospective study aimed to evaluate the cardiovascular examinations (CVE) documented on patients attending general paediatric outpatient clinics. Methods We retrospectively reviewed the healthcare records of new patients attending general paediatric clinics in a DGH during a one month period. Data gathered included patient demographics, presenting complaint (PC), CVE performed and referral for cardiovascular services. A questionnaire was also circulated to the consultant staff related to their views on the symptoms that would need such an assessment. Results 86/137 (62.8%) children received a CVE, consistent with the expectations gathered from the clinicians survey. There was no statistically significant association between PC (p=0.078), patient age (p=0.703), consulting clinician (p=0.488), and the completion of a CVE. Cardiovascular symptoms formed the presenting complaint in 7/137 (5.1%) of children, only one of whom received a full CVE. All these children received a CVE, but only one child received a full examination. However, it is reassuring that these 7 children received a more complete examination (4.43/8 aspects assessed) than the rest of the study group ( Conclusion Only two thirds of children attending a general paediatric clinic received any form of cardiovascular examination, and only one child out of 4 received a full assessment prior to referral to the cardiac service. A standardized paediatric clinical examination template for the outpatient clinics would help to improve the situation. However, Clinicians must also weigh-up the benefits of performing an extensive CVE within the time constraints of a busy clinic