Revista Científica de la Sociedad Española de Medicina de Urgencias y Emergencias

PAC Begoña - Bilbao - Osakidetza/Servicio Vasco de Salud, Spain.

Objective: Overcrowding is a significant problem for pediatric emergency departments
of hospitals. Some of the patients brought to such services could receive care outside the
hospital. Our objective was to determine demand for pediatric care at an urban urgent
care center that ensured 24-hour coverage; care was provided by non-pediatricians who
received training in pediatric urgent care.
Methods: Retrospective, descriptive, observational study of patients under the age of 14
years treated at an urban urgent care center in 1 year. We analyzed sociodemographic
data, reasons for consulting, diagnoses, treatments, and referral or not to a hospital.
Results: A total of 2711 requests for pediatric urgent care were managed at this center.
The most frequent reasons for seeking care were fever (30.3%), respiratory symptoms
without breathing difficulty (29.5%), skin lesions (11%), and blunt trauma or cuts
(10%). The main diagnoses were upper respiratory tract infection (21.5%), sore throat
or tonsillitis (14.4%), fever syndrome (13.8%), and cuts and blunt trauma (10%). The
most commonly prescribed treatments were antipyretics, analgesics (paracetamol and/or
ibuprofen), and/or written or verbal recommendations (57%), and antibiotics (24.2%).
The patient was referred to a hospital in 5.7% of the cases, most often for treatment of
blunt trauma or cuts (35.7%).
Conclusions: Fever and respiratory symptoms in the absence of respiratory difficulty
were the reasons for seeking care for most pediatric patients. Most cases could be
managed on the basis of physical examination and history taking. This type of urgent
care center is a promising approach to reducing hospital emergency department
overcrowding.