Table 2.

Observation Unit Entry Criteria

Hospital	Entry Criteria	Age Range	Time	Exclusion Criteria
King's County Downstate Brooklyn	Otherwise required inpatient admission Acute problem of uncertain severity Acute problem not readily diagnosed Diagnostic procedures impractical as outpatient	0 – 13 yrs	Maximum 24 hours	Not reported
			Short course periodic treatment
Children's Hospital Buffalo	Admission from any source Short stay elective surgery Estimated length of stay < 24 hrs	0 – 21 yrs	Maximum 24 hours	Intensive care needs Routine diagnostic tests Holding prior to admission
Children's National DC	Inadequate response to 3 subcutaneous epinephrine injections	8mos – 19 yrs	Not reported	Not reported
Children's Memorial Chicago	Asthma: Available parent Asthma score <=5 Inadequate response to ED treatment	>1 year	Maximum 24 hours	Past history of BPD, CF, CHD, other debilitating disease
	Dehydration: Cases receiving oral hydration Parent preference if given IV hydration	3 – 24 mos	12 hrs for oral 8 to 12 hrs for IV	Intensive care need Hypernatremia
Minneapolis Children's	Conditions listed in Table 3	Not reported	Maximum 10 hours	Not reported
Children's Hospital Boston	“Straightforward” diagnoses as determined by ED staff Bed availability	Not reported	Not reported	Other complex medical issues
Connecticut Children's	PEM attending discretion	Not reported	After 3–4 hrs in ED	Asthma: no supplemental O2 need, nebulized treatments > Q2hr
	Limited severity of illness Usually confined to a single organ system Clearly identified plan of care		Low likelihood of requiring “extended care” >23 hours	Croup: no supplemental O2 need, <2 racemic epinephrine treatments
				Dehydration: inability to tolerate orals, bicarbonate >10, 40cc/kg IVF
				Seizure: partial or generalized, postictal, unable to tolerate orals
				Poisoning: mild or no symptoms, poison control recommendation
Children's Hospital Denver	Intussesception: following reduction	0 – 18 years	After 3–4 hrs in ED	Not reported
	Dehydration: Based on clinical status
John Hopkin's Bayview	Consultation with on-duty pediatrician	0 – 18 years	Minimum of 2 hrs High likelihood of discharge at 24 hrs	Patients requiring subspecialty or intensive care services
Children's Hospital of Philadelphia	Sole discretion of the ED attending Single focused acute condition Clinical conditions appropriate for observation	Not reported	Minimum 4 hours Maximum 23 hours	No direct admissions Diagnostic dilemmas Underlying complex medical problems
Primary Children's Medical Center	Observation unit attending discretion Scheduled procedures as space available ED admit after consult with OU doctor Clear patient care goals Limited severity of illness Diagnostic evaluation	0 – 21 years	Minimum 3 hours Maximum 24 hours	Admission “holds” Intensive care needs Complicated, multi-system disease Need for multiple specialty consults Psychiatric patients