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Recém-nascido no Serviço de Urgência – casuística do ano 2011 de um Centro Hospitalar
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Advisor(s)
Abstract(s)
Introdução: O nascimento de um filho é um desafio para os
pais. Assim, no período neonatal, surgem frequentemente dúvidas
que motivam a ida ao Serviço de Urgência (SU), muitas
vezes sem justificação clínica.
Objetivos: Caracterizar as admissões de recém-nascidos (RN) no SU num período de 12 meses e avaliar a justificação do
atendimento pediátrico urgente.
Material e métodos: Análise retrospetiva dos episódios de urgência dos RN que recorreram ao nosso hospital entre Janeiro
e Dezembro de 2011.
Resultados: No período em estudo, recorreram 394 RN (20% foram observados em mais do que uma ocasião), representando
1,3% das admissões no SU Pediátrico; 20% referenciados
por profissionais de saúde. Os principais motivos de recurso
foram queixas gastrointestinais (31%), lesões cutâneo-mucosas
(18%), icterícia (17%) e queixas respiratórias (15%). Foram realizados
exames complementares em 44% das admissões, sendo
os mais frequentes, bilirrubina transcutânea e análise de urina.
Instituiu-se terapêutica em 18% dos casos. Os diagnósticos mais
frequentes corresponderam a patologia neonatal benigna e problemas
de puericultura em 57% dos casos (n=283). A maioria
dos RN (75,6%) teve alta para o domicílio. A mediana da idade
materna foi de 30 anos e 58,6% eram primíparas. Metade das
mães cuja escolaridade foi conhecida tinham concluído o nono
ano.
Conclusões: A maioria dos recursos ao SU hospitalar no
período neonatal corresponde a situações não urgentes que
poderiam ser resolvidos nos Cuidados Primários de Saúde.
Salienta-se a importância do esclarecimento das mães durante
a gravidez e período neonatal. Por outro lado, a inespecificidade
de sintomas nesta faixa etária exige um maior nível de alerta
para as situações potencialmente graves.
Introduction: The birth of a child is a challenge for parents. Thus, during the neonatal period many questions arise to parents, leading to frequent visits to the Emergency Department (ED), often unjustified from a clinical point of view. Objectives: Characterization of newborn visits to the paediatric ED for a 12 months’ period, and evaluation of the need for emergency paediatric care.. Material and methods: Retrospective study of all neonates’ visits to the ED in our hospital from January to December 2011, analysing clinical and demographic data. Results: During the study period, a total of 394 neonates were admitted in the ED (20% visited more than once), representing 1,3% of all paediatric visits; 20% were referred by health professionals. The main causes of ED utilisation were alimentary tract complaints (31%), dermatological issues (18%), jaundice (17%) and respiratory symptoms (15%). Diagnostic tests were required in 44%, mostly transcutaneous bilirubin measurement and urine analysis. Only 18% of the patients received treatment. The most frequent diagnoses were benign neonatal pathology and healthy care child issues in 57% of cases (n=283). The majority of neonates (75,6%) was discharged. 56,8% of mothers were primiparous and the median maternal age was 30 years. Half of the mothers with known literacy skills, studied during more than nine years. Conclusions: Most neonatal utilisation of emergency paediatric services is due to non-urgent conditions that could be managed in primary care. We underline the importance of proper support and education of mothers during pregnancy and neonatal period. Nevertheless due to the lack of specificity of the neonatal symptoms, paediatricians must be alert to rule out severe disease.
Introduction: The birth of a child is a challenge for parents. Thus, during the neonatal period many questions arise to parents, leading to frequent visits to the Emergency Department (ED), often unjustified from a clinical point of view. Objectives: Characterization of newborn visits to the paediatric ED for a 12 months’ period, and evaluation of the need for emergency paediatric care.. Material and methods: Retrospective study of all neonates’ visits to the ED in our hospital from January to December 2011, analysing clinical and demographic data. Results: During the study period, a total of 394 neonates were admitted in the ED (20% visited more than once), representing 1,3% of all paediatric visits; 20% were referred by health professionals. The main causes of ED utilisation were alimentary tract complaints (31%), dermatological issues (18%), jaundice (17%) and respiratory symptoms (15%). Diagnostic tests were required in 44%, mostly transcutaneous bilirubin measurement and urine analysis. Only 18% of the patients received treatment. The most frequent diagnoses were benign neonatal pathology and healthy care child issues in 57% of cases (n=283). The majority of neonates (75,6%) was discharged. 56,8% of mothers were primiparous and the median maternal age was 30 years. Half of the mothers with known literacy skills, studied during more than nine years. Conclusions: Most neonatal utilisation of emergency paediatric services is due to non-urgent conditions that could be managed in primary care. We underline the importance of proper support and education of mothers during pregnancy and neonatal period. Nevertheless due to the lack of specificity of the neonatal symptoms, paediatricians must be alert to rule out severe disease.
Description
Keywords
Acesso a cuidados de saúde recém-nascido urgência pediátrica Access to health care newborn infant paediatric emergency department
Citation
Nascer e Crescer 2014; 23(1): 12-16
Publisher
Nascer e Crescer