Evaluation of Emergency Service Applications of Home Mechanical Ventilator Dependent Children

Abstract

Introduction:There has been an increase in the number of patients using home mechanical ventilator for suffering from chronic respiratory failure, due to the recent technological developments and increasing experience. The aim of this study is to determine the most common reasons for emergency admissions and treatments applied, and the most frequent reasons for hospitalization.Methods:Mechanical ventilator dependent children, who were admitted to the Ankara University Faculty of Medicine and Health Sciences University Ankara Pediatric Health and Disease Hematology Oncology Training and Research Hospital Emergency Services between October 2014 and October 2015, were evaluated retrospectively.Results:Seventy-one patients were included in the study. The median age was 42 months and 40 of them (56.3%) were male. The mean duration of mechanical ventilation was 15.0 months. The most common complaint for being admitted to the emergency department was decreased oxygen saturation (14.1%); 17 patients (23.9%) were admitted to the emergency department due to non-emergent reasons. The median number of applications within one year was 3. Twenty-six patients (36.6%) were hospitalized. The most common reason for hospitalization was pneumonia (26.8%). When the resource usage was evaluated according to the five-step triage system, 97.1% of the patients used 2 or more resources in the emergency department.Conclusion:It was found that emergency department admissions and hospital resource usage were higher in the children who were followed with home mechanical ventilator. The reason for the increased number of emergency room admissions may be due to applications for non-urgent reasons.

Keywords

• home mechanical ventilator
• child
• pediatric emergency
• gastrostomy