• emergency department
• anaphylaxis/allergy
• emergency care systems

Dear Editor

In 2017, the NHS in England introduced the Emergency Care Data Set (ECDS) to standardise approaches to ED digital data collection in order to be able to meaningfully compare practice and improve quality of care. It contains 108 data fields including patient demographics, episode information (ie, arrival time and date) and clinical information. SNOMED CT1, an internationally validated structured clinical vocabulary for use in an electronic health record, was used to derive a limited number of subgrouped conditions as part of the diagnosis field. In the subgroup ‘allergy’, we noted the ECDS contained only eight possible diagnoses (Hayfever, Anaphylaxis, ACE Inhibitor Related Angioedema, Angio-oedema: hereditary C1 esterase inhibitor deficiency, Angio-oedema: acquired C1 esterase inhibitor deficiency, Scombroid toxin, Drug reaction and other allergic reaction). In a retrospective evaluation, for those children referred to an allergy clinic, we compared the ECDS discharge diagnosis coded on our electronic health record (Nervecentre V.5.0.1 2018 Nervecentre Software) by the treating clinician with their written ED record in the clinical notes and the final diagnosis from clinic. All …