Red Code Management in a Pediatric Emergency Department: A Retrospective Study

The "red code" (RC) represents the highest level of emergency in the emergency department (ED). This study retrospectively analyzed RCs in the Regina Margherita Children's Hospital ED, a regional referral center in north Italy, between 1 July 2020 and 30 June 2023. The aim was to desc...

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Bibliographic Details
Published in:Children (Basel) 2024-04, Vol.11 (4), p.462
Main Authors: Bertone, Serena, Denina, Marco, Pagano, Manuela, Delmonaco, Angelo Giovanni, Castagno, Emanuele, Bondone, Claudia
Format: Article
Language:English
Subjects:
Analysis
Chronic illnesses
Consciousness
diagnostic pathways
emergency department
Emergency medical care
Emergency service
Epidemiology
Health aspects
Hospitals
Medical care
Medical diagnosis
Metabolism
Mortality
Patients
Pediatric emergencies
Pediatrics
Point of care testing
Quality management
red code
Skin
Statistical analysis
Venous access
Vital signs
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Summary:The "red code" (RC) represents the highest level of emergency in the emergency department (ED). This study retrospectively analyzed RCs in the Regina Margherita Children's Hospital ED, a regional referral center in north Italy, between 1 July 2020 and 30 June 2023. The aim was to describe RC characteristics and to identify significant correlations between presenting complaints and clinical management. The study includes 934 RCs (0.9% of overall ED admissions); 64% were assigned based on the Pediatric Assessment Triangle alteration. Most patients, 86.5%, followed the medical pathway, while 13.5% were surgical cases. Admission complaints were respiratory (46.9%), neuropsychiatric (26.7%), traumatic (11.8%), cardiologic (9.3%), metabolic (3.8%), and surgical (1.5%). Seventy-six percent of patients received vascular access, and intraosseous access was obtained in 2.2% of them. In one-third of RCs, an urgent critical care evaluation was necessary, and 19% of cases required admission to the intensive care unit. The overall mortality rate was 3.4% (0.4% in ED setting). The study identified six distinct diagnostic pathways, each associated with specific characteristics in clinical presentation, management, therapeutic interventions, and outcomes. Our findings underscore the need for a systematic approach in pediatric emergency settings, supported by international and national guidelines but also by clearly defined diagnostic pathways, aiming to enhance the quality of care and patient outcomes.
ISSN:2227-9067
2227-9067
DOI:10.3390/children11040462