• Nicola Sparrow, Trudie Pestell, and Mike Clancy.
• Emergency Department, University Hospitals Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
• Emerg Med J. 2015 Sep 1; 32 (9): 712-5.

IntroductionChildren who attend an emergency department and then leave without being seen (LWBS) are a major concern as they are a potentially vulnerable group who may come to harm through failure to provide a timely and accessible service.ObjectivesWe wished to establish the size of this population and importantly what subsequently happened to them over the following 7 days from their initial attendance, and the relevance of the College of Emergency Medicine LWBS Quality Indicator (QI 4) to this group.MethodsA retrospective case note review over 6 months of all paediatric attendances who LWBS.SettingSouthampton Paediatric Emergency Department.ResultsDuring a 6-month study period, 10 795 attended, of which 544 (5%) LWBS. 12.6% (69/544) reattended over the next 7 days, of which 14 were admitted, 7 for <12 h.ConclusionsThe majority who LWBS do so during peak times. Very few paediatric patients who LWBS then reattended required admission for >12 h (7/544, 1.3%). The rate of reattendance of those who LWBS and review of their case notes is potentially more valuable than the LWBS rate alone.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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