Today saw the launch of two important documents dealing with different aspects of Paediatric Emergency Medicine (PEM). Both documents involved significant updates to work which the Association was previously involved in.
Paediatric Emergency Medicine – Development to Date and Future Direction sets out a roadmap for the development of PEM in Ireland and builds on a 2010 document published by the Association which set out the initial steps on the journey. Eleven years on, the foundations are in place and the task now is to broaden the reach of PEM into hospitals which hitherto haven’t had the benefit of this specific expertise to take the lead on the assessment and management of children presenting as emergencies. The Association looks forward to the recognition by the Medical Council of PEM as a separate medical specialty, open to those who have trained to specialist level in either Emergency Medicine or General Paediatrics and who have gone on to complete specific PEM training and also seeing a significant increase in the number of Consultants in PEM around the country, starting with those Emergency Departments (EDs) which will be the hubs of the nascent Emergency Care Networks (ECN). Planned expansion of Consultant in PEM numbers associated with the development of the National Children’s Hospital has been well flagged but there is also a need to ensure parallel recruitment to the larger mixed EDs which see both adults and children. These mixed EDs outside of Dublin will continue to see children presenting as emergencies in numbers that, when taken in aggregate, will equal or outnumber those presenting to the ED and Urgent Care Centres that will comprise an ECN for children in the Greater Dublin Area.
The Irish Children’s Triage System, first piloted in 2013, has also been updated. This tool which was developed for use in both Paediatric and mixed EDs provides a consistent national approach to prioritise the care of children who attend an Irish ED. Senior, experienced paediatric ED nurses and colleagues from PEM in Ireland developed, piloted, evaluated and validated this tool which has been well received countrywide. The developers studied the surprisingly few similar tools from around the world (given the very different reasons that drive emergency presentations in children compared to adult presentations) and developed one which has been shown to work well in an Irish context and no doubt will be copied in other jurisdictions. The inclusion of more nuanced age-specific pain scores is one of the changes in the 2nd Edition. As increasing numbers of children are living longer with certain congenital conditions that previously led to death in early childhood, the need to recognise their particular risks was another driver for the update to the tool to ensure that it remains fit-for-purpose in 2021 and beyond.
The two documents were launched today at a webinar hosted by the Emergency Medicine Programme. Contributing to the webinar were speakers from Emergency Medicine, Paediatric Emergency Medicine and Paediatric Nursing, with opening remarks from Dr Colm Henry, Chief Clinical Officer, HSE. The Association acknowledges the work of all those who contributed to both these landmark documents, their important updates and their contribution to the care of children presenting to EDs and associated units in Ireland.