[Telephonic advice by an emergency department given in a simulated pediatric case].
BACKGROUND
Emergency departments (ED) are requested everyday to dispense medical telephone advice for children. To evaluate the quality of telephone management, a mock scenario simulating a febrile 4 month-old-girl with signs compatible with septicemia was used.


METHODS
One hundred randomly selected French emergency departments were called on. Half of the hospitals had a pediatric department with more than 20 beds; the other half did not have a pediatric department. A research technician called and said: "My baby has got fever and I do not know what to do". Additional information was given only on request.


RESULTS
Ninety-four ED gave medical advice by telephone: 65% of the cases by a physician, 24.5% by a nurse, 9.5% by a nurse technician and 1% by a secretary. In hospitals without a pediatric department, physicians took calls in 76.5% of the cases, whereas in hospitals with a pediatric department they only took calls in 53% of the cases. The mean number of questions asked per ED was 3.1. The age of the child was requested by 87.2% of the respondents. Advice was given by 36.1% of the ED without asking either the age of the patient or grade of the fever. The advice given by the respondents was: come to the ED immediately (30.9%), see a community physician immediately (51%), come to the ED tomorrow (2.1%), see a community physician tomorrow (8.5%), and manage at home (7.5%).


CONCLUSIONS
This study has shown important inadequacies in pediatric telephone advice given by some ED. It suggests that the respondents do not use a protocol to handle the calls; development of such protocols to guide the histories taken and advice given for the most common telephone queries is urged.
Carbajal
R
R
Département accueil-urgences, Centre hospitalier de Poissy, France.
Barthez
P
P
Blanc
P
P
Paupe
A
A
Lenclen
R
R
Olivier-Martin
M
M
Simon
N
N
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003376:Counseling / Q000379:methods* / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005602:France; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D016544:Patient Simulation; D010564:Personnel, Hospital; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019114:Remote Consultation; D013689:Telephone
Conseils téléphoniques donnés aux urgences pour un cas pédiatrique simulé.