Outpatient management of the severely ill child. A timed priority system.

Abstract

Increasing use of hospital emergency services has created many problems in patient management. A small percentage of children seeking emergency services is seriously ill. The identification of these patients and the careful monitoring of their outpatient evaluation requires an organized approach. A system, utilizing a method of selecting appropriate patients while setting a time for their evaluation and disposition, has been established and its effectiveness appraised. Under this system, 348 children were selected for special monitoring from a possible 26,910 patients registering in a short-term care clinic. Ninety-three percent of these children were found to be seriously ill while 54.8% required hospital admissions. In addition, the major factors affecting the time needed for evaluation were analyzed. The average time required to arrive at a complete evaluation and disposition was one hour, 42.setunim