[Predicting the use of Emla cream by the triage nurse in a paediatric emergency department].
BACKGROUND
The current issue of paediatric emergency care is to decrease the length of stay of the child and his/her family in the emergency department while improving health care quality. Up to now, the paediatric emergency department's triage nurses of the children's Timone hospital apply two EMLA patches when they think that a blood test will be ordered by the medical doctor in order to decrease the waiting time between the clinical exam and the blood test.


OBJECTIVE
The objective of this study was to check if this attitude allowed to efficiently select children who will actually get a blood test.


METHODS
During four weeks, the triage nurses were asked to write down for each patient after the reception time whether or not a blood test would be ordered by the medical doctor after clinical exam. We compared these data to the number of blood tests actually done.


RESULTS
Out of the 2758 children admitted in the emergency department during this period, 1973 nurse prediction forms were filled out. The triage nurses predicted a blood test for 253 patients. Out of these 253 patients, only 132 of them had a blood test done. The study of various studied criteria did not allow to reveal any good agreement between the nurse and the medical doctor.


CONCLUSIONS
The literature study shows that some medical criteria allow to improve this agreement rate. The assessment of blood test necessity have to be carried on and needs further studies in order to precise the most discriminant medical criteria.
Service des urgences pédiatriques, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. franck.launay@mail.ap-hm.fr <franck.launay@mail.ap-hm.fr>
F
F
Launay
E
E
Viehweger
A
A
Hamel
P
P
Minodier
H
H
Le Hors-Albouze
J L
JL
Jouve
D001774:Blood Chemical Analysis / Q000706:statistics & numerical data; D002648:Child; D016529:Emergency Nursing; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments / Q000627:therapeutic use*; D010371:Pediatric Nursing; D011318:Prilocaine / Q000627:therapeutic use*; D014218:Triage
D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine