title: Children who leave the emergency department without being seen: a retrospective case note review.
abstract: BACKGROUND
  Children who attend an emergency department and then leave without being seen (LWBS) are a major concern as they are a potentially vulnerable group who may come to harm through failure to provide a timely and accessible service.
  
  
  OBJECTIVE
  We wished to establish the size of this population and importantly what subsequently happened to them over the following 7 days from their initial attendance, and the relevance of the College of Emergency Medicine LWBS Quality Indicator (QI 4) to this group.
  
  
  METHODS
  A retrospective case note review over 6 months of all paediatric attendances who LWBS.
  
  
  METHODS
  Southampton Paediatric Emergency Department.
  
  
  RESULTS
  During a 6-month study period, 10 795 attended, of which 544 (5%) LWBS. 12.6% (69/544) reattended over the next 7 days, of which 14 were admitted, 7 for <12 h.
  
  
  CONCLUSIONS
  The majority who LWBS do so during peak times. Very few paediatric patients who LWBS then reattended required admission for >12 h (7/544, 1.3%). The rate of reattendance of those who LWBS and review of their case notes is potentially more valuable than the LWBS rate alone.
authors.affiliation: Emergency Department, University Hospitals Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Sparrow
authors.affiliation: Emergency Department, University Hospitals Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
authors.forename: Trudie
authors.initials: T
authors.lastname: Pestell
authors.affiliation: Emergency Department, University Hospitals Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Clancy
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D013997:Time Factors; D014218:Triage; D014850:Waiting Lists
keywords: emergency department; paediatrics