An audit of dermatology in a paediatric accident and emergency department.
Two studies were undertaken of patients with dermatological disorders who attended the Accident and Emergency (A&E) Department of the Royal Belfast Hospital for Sick Children during 1990-1991. The aims were to review diagnostic accuracy and assess the benefits of an open-access consultant dermatology clinic. A retrospective survey of 14,340 new attendances at the A&E department over a 7-month period found that 540 of these (4%) had a primary dermatological disorder. In 26% no diagnosis had been made although only 10% were referred for a specialist opinion. A 2-month prospective study of patients who attended the department and were referred to a consultant dermatology open-access clinic revealed overall diagnostic accuracy of 66% (+/- 2 SEM). Individual rates of diagnostic concordance between junior doctor and consultant were 59% for skin infections and 77% for papulosquamous disorders. The open-access clinic allowed prompt referral for correct diagnosis and initiation of appropriate management.
Dolan
O M
OM
Department of Dermatology, Royal Belfast Hospital for Sick Children, Northern Ireland.
Bingham
E A
EA
Glasgow
J F
JF
Burrows
D
D
Corbett
J R
JR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003880:Dermatology / Q000592:standards*; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006776:Hospitals, Pediatric / Q000592:standards; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012871:Skin Diseases / Q000175:diagnosis