Prioritising minimum standards of emergency care for children in resource-limited settings.
BACKGROUND
There is global variation in the ability of hospital-based emergency centres to provide paediatric emergency medicine (PEM) services. Although minimum standards have been proposed, they may not be applicable in resource-limited settings.


OBJECTIVE
The goal was to identify reasonable minimum standards to provide safe and effective care for acutely ill children in resource-limited settings.


METHODS
Using previously proposed standards from the International Federation of Emergency Medicine (IFEM), a modified Delphi approach was used to reach agreement regarding minimum standards for PEM in resource-limited settings. Three rounds of surveys were electronically distributed to physicians working in resource-limited settings. Those standards with >67% agreement advanced to the subsequent round.


RESULTS
The categories of the surviving criteria included integrated service design, child and family-friendly care, initial assessment of the ill child, stabilising and treating an ill child, staff training and competence, equipment, supplies and medications, quality and safety, child protection, and advanced training and academic research.


CONCLUSIONS
Experts with experience in acute care of children in resource-limited settings have prioritised standards for paediatric emergency care. They identified 26 variables in nine domains from the original IFEM list of standards and two additional free text standards for the care of acutely ill children. This list may serve as a helpful guide for emergency centres to provide medical treatment for acutely ill children in resource-limited settings.
a Section of Emergency Medicine , University of California San Francisco , San Francisco , California.
Nicolaus W
NW
Glomb
b Sections of Emergency Medicine.
Manish I
MI
Shah
b Sections of Emergency Medicine.|c Infectious Diseases , Baylor College of Medicine , Houston , Texas , USA.
Andrea T
AT
Cruz
D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy*; D003906:Developing Countries; D004632:Emergency Medical Services / Q000379:methods* / Q000458:organization & administration*; D006776:Hospitals, Pediatric; D006801:Humans; D059039:Standard of Care
Emergency; Global health; International; Paediatric; Standards of care