Paediatric escalation area and corridor care in the Emergency Department, a secondary analysis of the UNCORKED study
Abstract
Objective: To describe the use of, and outcomes following, Emergency Department (ED) escalation area care among children.
Design: Two-stage prospective multicentre observational study. Stage one was a cross-sectional snapshot study reporting the point prevalence of escalation area care; stage two was an observational cohort study of eligible participants present in the EDs during snapshots.
Setting: 5 snapshots of 96 type 1 UK EDs. 83/96 (86.5%) of sites were mixed EDs and 13 sites were paediatric-only EDs.
Patients: Patient level data was collected on those who experienced escalation area care and/or were admitted.
Outcomes: The primary outcome was the proportion of patients cared for in escalation areas in paediatric-only EDs. Secondary outcomes were demographics, length of stay (LOS), 28-day mortality, type of escalation area experienced and time in escalation areas in all ED types; stratified by escalation area experience.
Results: 6.6% (n=75/1132) of patients in paediatric-only EDs were receiving escalation area care during the study snapshots, the majority of this occurred in a minority of departments. Across all ED types, 15.4% (n=104/675) of admitted children experienced escalation area care during their ED stay. 124/244 (50.8%) of those cared for in escalation areas were cared for in a non-clinical area such as a corridor. 9.6% (n=8/83) of mixed EDs reported caring for adults in paediatric areas. Three children died within 28 days; all admitted to hospital without…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 104 participants or records.
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