Pediatric preparedness of european emergency departments; a multicenter international survey

Introduction: Children and adolescents often lack optimal emergency care. The objective of the study was to assess the level of preparedness of European emergency departments (EDs) for pediatric patients. Methods: This was an international multicenter Internet-based survey of EDs with attending children and adolescents younger than 18 years in 101 EDs from 21 countries. Questionnaires were based on the recommendations in the consensus document published by the International Federation for Emergency Medicine, which defines quality of care standards for children aged 0 to 18 years in the ED. A multivariate binary logistic regression was performed to identify independent factors that are related to the expected standards of care provided by the EDs. Results: Most (95.0%) of the EDs fulfilled more than 50%of the International Federation for Emergency Medicine essential standards of care, and 24 (23.7%) EDs fulfilled more than 80%. Best results were obtained in the standards that related to equipment, departmental policies, procedures, and protocols, and being able to stabilize an ill or injured child. Worst results were associated with inadequate staffing levels, quality, and safety; adolescents, mental health, and substance misuse delivery issues; and major incidents. Being included in a multicenter international research network was the unique independent factor associated with a good level of preparedness of the EDs for pediatric cases. Conclusions: Overall, surveyed European EDs fit well the essential standards of pediatric emergency care. Certain improvement actions are required to guarantee that essential standards of care for pediatric emergency care are always fulfilled in European EDs.