A Retrospective Single-center Study on Time Critical Neurological Disorders in the Emergency Room of a Tertiary Pediatric Center

Background: Teams of pediatric emergency rooms (ER) are very often confronted with patients presenting due to acute neurological symptoms. Disorders include several less time critical diseases (i.e. migraine) as well as some less commonly encountered conditions, that however demand for a very urgent management (i.e. childhood stroke). In this context, the subgroup of children presenting due to acute onset focal neurological symptoms represent a very important subgroup (keyword: brain attack (BA). In our ER, triage of patients is based on the emergency severity index (ESI) und the Face-Arm-Speech-Time-test (FAST), an adult stroke screening tool that has been evaluated in children previously. So far, no sufficiently sensitive tool exists to recognize or discriminate childhood brain attacks promptly and efficiently. The aim of this study was the investigation of more recent tools as the Balance-Eyes-FAST-test (BEFAST) and the Munich Early Recognition of Childhood Stroke (MERCS) – a pocket card developed by our working group to optimize the management pathways for children presenting with BA.