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ACEP Now: Vol 41 – No 04 – April 2022

Figure 2: Percentage of patients in general service EDs over age 64, by ED cohort.

What Other Factors May Be Contributing to the Decrease in ED Visits by Children?

There are increasing pathways to unscheduled care for children and their parents. That includes expanded hours for pediatricians, the larger presence of urgent care centers in many metropolitan areas and the emerging presence of telehealth.

The role of emergency physicians has dramatically changed in response to the COVID-19 pandemic, and trends suggest emergency departments will see older, higher-acuity patients with more complex medical needs.⁵ The emergency department remains the portal for all patients, and general service emergency departments must be prepared for persons of any age. Even if the inpatient areas of the hospital do not care for children, the emergency department must provide initial care for all who will either be admitted or transferred. Recent publications point to the need for all emergency departments to be better prepared for ill or injured children and include access to preparedness materials.^3,4

Thirteen percent of children present to community emergency departments these days. The relative infrequency of pediatric ED patients must not change the need to be prepared to care for them, including the equipment, processes, and training available in general service emergency departments.

References

1. Welch S, Augustine J, Camargo CA Jr, et al. Emergency department performance measures and benchmarking summit. Acad Emerg Med. 2006;13(10):1074-1080.
2. Cairns C, Kang K, Santo L. National Hospital Ambulatory Medical Care Survey: 2018 emergency department summary tables. Centers for Disease Control and Prevention.
3. Newgard C, Lin A, Goldhaber-Fiebert JD, et al. Association of emergency department pediatric readiness with mortality to 1 year among injured children treated at trauma centers [published online ahead of print February 2, 2022]. JAMA Surg.
4. Remick K, Gausche-Hill M, Joseph MM, et al. Pediatric readiness in the emergency department. J Emerg Nurs. 2019;45(1):e3-e18.
5. Augustine JJ. Pre-COVID ED trends suggest more challenges lie ahead. ACEP Now. 2020;39(11):10.