Organisation of Paediatric Emergency Care in Europe

Paediatric Emergency Medicine (PEM) is a relatively new and rapidly evolving subspecialty, and in other parts of the world it is now established as a Board-certified paediatric subspecialty. In Europe, PEM has been growing in many countries, even if very heterogeneously. In the UK, PEM has received official recognition in 2003. In France, Italy, Spain, Switzerland, and Sweden, PEM is not yet recognised, but it is practised by an increasing number of paediatricians in 3rd-level Paediatric Emergency Departments. A WG on PEM convened in Paris on 18-19th September 2009 with the aim of writing an European Training Syllabus on PEM to be approved by both the European Academy of Paediatrics (EAP) and the Multiple Joint Committee (MJC) on EM. During the meeting, the various organisations of PEM were reviewed in the above-listed countries. Although the organisation of PEM was very heterogeneous between the various countries, some common features emerged: 1) the wide range of pathologies from life-threatening to self-limiting; 2) the increasing attendance, particularly at nights and the week-ends, reflecting a lower coverage of primary care; 3) the impact of winter epidemics (eg, bronchiolitis, gastro-enteritis, influenza A H1N1 (2009) on the attendance; 4) the critical importance of a good triage system and timely clinical-making decision; 5) the necessary good communication between PEM physicians and other hospital specialists including paediatric surgeons. Thus, the approval of the European Training Syllabus on EM by both the EAP and MJC on EM should help develop PEM throughout the EU on more homogeneous grounds.