ADULTS IN THE PEDIATRIC EMERGENCY DEPARTMENT - A FISH OUT OF WATER

Adults (>17 years) occasionally seek care in pediatric emergency depar tments (FED), We reviewed the records of adults treated in our PED fro m September 1992 to August 1993 to better understand their needs, Pati ents were classified based on their relationship to our hospital: 1) n o previous medical care association (new), and 2) adult patients follo wed in our clinics for chronic diseases (chronic). Data were analyzed using frequencies and comparison of means by Student's t test or chi(2 ). A follow-up phone cad or written survey was used to assess quality of care and satisfaction, Of 40,895 patients, 384 were adults (0.9%), Ages ranged from 18 to 73 years (median = 21 years, mean = 25 years) w ith 49% men, Most adults were seen between 3:00 PM and 10:59 PM; 84% w ere triaged as urgent or emergent, There were 140 new, and 230 chronic , patients, Fourteen were not classified because of lack of informatio n, The mean age of new adults was 33 years, median 29 years; 53% were hospital employees, Forty percent of new adults had preexisting illnes ses, Most common problems were cardiac/hypertension (27%), blunt traum a (22%), eye splash (13%), and lacerations (9%), Forty eight percent w ere transferred to an adult hospital, and 20% of transferred patients were admitted overnight, Chronic adult patients were younger (mean 21 years, P < 0.001); fever/infection (37%), minor trauma (17%), and gast rointestinal problems (12%) predominated; 36% were admitted, The avera ge time in the FED was 70 minutes for new and 202 minutes for chronic patients (P < 0.001), Conclusions: Chronic patients present with probl ems much like those of their younger counterparts, and the FED is prep ared to manage them, New adult patients present with adult problems: c hest pain, hypertension, blunt trauma, and eye foreign body, and the F ED should be prepared to manage these.