The adult patient in the pediatric emergency department.
OBJECTIVE
To establish the frequency of use of pediatric emergency departments by adult patients and the spectrum of disease with which they present.


METHODS
Prospective, descriptive study and unblinded survey.


METHODS
Children's Hospital pediatric ED.


METHODS
Seventy-two adult patients presenting to a pediatric ED during a two-year period and 31 pediatric emergency medicine fellowship directors.


METHODS
For each patient, we recorded demographic information, chief complaint, interventions by physicians, diagnosis, condition, and disposition after initial care. Pediatric emergency medicine fellowship training program directors were surveyed by telephone regarding their experiences with adult patients and the extent of adult emergency medicine training within their programs.


RESULTS
Of the 72 adult patients evaluated, one third (22) were treated for trauma and the remaining 50 for medical illness. More than 40 different diagnoses were encountered, including stroke and myocardial infarction. Twenty patients (27.8%) required hospitalization, four (5.6%) in intensive care settings. Of the 31 fellowship directors surveyed, 27 (87.1%) indicated that adult patients had been managed in their EDs during the previous year. All but one reported that their fellowship programs incorporated between one and four months of adult emergency medicine in their curricula.


CONCLUSIONS
Adults frequently present to pediatric EDs for both minor and serious illnesses. Training in adult emergency medicine should be a part of all pediatric emergency medicine fellowship programs.
Division of General Pediatrics, Children's Hospital of Philadelphia.
M D
MD
Baker
G R
GR
Schwartz
S
S
Ludwig
D000328:Adult; D000368:Aged; D004635:Emergency Medicine / Q000193:education; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005257:Fellowships and Scholarships; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010372:Pediatrics / Q000193:education; D015143:Philadelphia; D011446:Prospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology