Pediatric Vital Signs Documentation in a Nationally Representative US Emergency Department Sample.

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  • Additional Information
    • Source:
      Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 101585349 Publication Model: Electronic Cited Medium: Internet ISSN: 2154-1671 (Electronic) Linking ISSN: 21541671 NLM ISO Abbreviation: Hosp Pediatr Subsets: MEDLINE
    • Publication Information:
      Publication: July 2011- : Elk Grove Village : American Academy of Pediatrics
      Original Publication: Elk Grove Village, IL : American Academy of Pediatrics/Section on Hospital Medicine
    • Subject Terms:
      Vital Signs* ; Emergency Service, Hospital*/statistics & numerical data ; Documentation*/statistics & numerical data ; Documentation*/standards ; Documentation*/methods; Humans ; Cross-Sectional Studies ; Child ; Retrospective Studies ; Child, Preschool ; Adolescent ; Female ; United States/epidemiology ; Male ; Infant ; Hospitalization/statistics & numerical data ; Infant, Newborn ; Health Care Surveys
    • Abstract:
      Objectives: Vital sign measurement and interpretation are essential components of assessment in the emergency department. We sought to assess the completeness of vital signs documentation (defined as a temperature, heart rate, respiratory rate, blood pressure, and oxygen saturation) in a nationally representative sample of children presenting to the emergency department, characterize abnormal vital signs using pediatric advanced life support (PALS) criteria, and evaluate their association with hospitalization or transfer.
      Methods: We conducted a retrospective, cross-sectional study using the 2016-2021 National Hospital Ambulatory Medical Care Survey. We evaluated the proportion of children (aged ≤15 years) with complete vital signs and identified characteristics associated with complete vital signs documentation. We assessed the proportion of children having abnormal vital signs when using PALS criteria.
      Results: We included 162.7 million survey-weighted pediatric encounters. Complete vital signs documentation was present in 50.8% of encounters. Older age and patient acuity were associated with vital signs documentation. Abnormal vital signs were documented in 73.0% of encounters with complete vital signs and were associated with younger age and hospitalization or transfer. Abnormal vital signs were associated with increased odds of hospitalization or transfer (odds ratio 1.51, 95% confidence interval 1.11-2.04). Elevated heart rate and respiratory rate were associated with hospitalization or transfer.
      Conclusions: A low proportion of children have documentation of complete vital signs, highlighting areas in need of improvement to better align with pediatric readiness quality initiatives. A high proportion of children had abnormal vital signs using PALS criteria. Few abnormalities were associated with hospitalization or transfer.
      Competing Interests: CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no conflicts of interest relevant to this article to disclose.
      (Copyright © 2024 by the American Academy of Pediatrics.)
    • Comments:
      Comment in: Hosp Pediatr. 2024 Jul 1;14(7):e311-e313. doi: 10.1542/hpeds.2024-007779. (PMID: 38910524)
    • Publication Date:
      Date Created: 20240624 Date Completed: 20240624 Latest Revision: 20240630
    • Publication Date:
      20240701
    • Accession Number:
      10.1542/hpeds.2023-007645
    • Accession Number:
      38910528