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• 特别策划·康复护理管理 • 上一篇    下一篇

儿科急诊潜在危重病的早期识别与管理

陈娟弟   

  1. 温州医科大学附属第二医院 育英儿童医院儿童门诊部
  • 出版日期:2014-11-25 发布日期:2014-11-25

The early recognition and management mode of potential critical diseases in pediatric emergency department

  • Online:2014-11-25 Published:2014-11-25

摘要: 目的:实施儿科急诊潜在危重病患儿的临床处理流程及管理方法,早发现、早识别、早治疗潜在危重病患儿,从而降低患儿死亡率,减少医疗纠纷。方法:建立儿科急诊预检分诊识别流程;制定早期筛选儿科急诊潜在危重病的临床方案。结果:2010-2013 年,我院实施儿科急诊潜在危重病的早期识别与管理后,早期发现了爆发性心肌炎10 例、肠道病毒71 型(EV71)感染重症病例9 例、脓毒症8 例、流行性脑脊髓膜炎2 例,阻止医疗纠纷10 例,发生医疗纠纷仅7 起,较2006-2009 年(实施前)发生的医疗纠纷减少8 起,死亡人数由163 例下降到118 例。结论:建立规范的儿科急诊潜在危重病患儿的临床识别流程及管理方法,能提高急诊医护人员早期识别儿科急诊潜在危重病的能力,降低患儿死亡率,减少医疗纠纷。

Abstract: Objective: To establish a clinical process flow and management mode of potential critical diseases in pediatric emergency department, in order to recognize and treat patients early to reduce mortality and avoid medical conflicts. Method:The recognition process of pediatric emergency triage was established; clinical scheme for early screening of potential critical disease in pediatric emergency department was enacted. Result: From 2010 to 2013, after application of clinical recognition process and management mode, 10 cases of fulminant myocarditis, 9 cases of EV71-associated severe infection; 8 cases of pyemia and 2 cases of epidemic cerebrospinal meningitis were early recognized, which helped avoid 10 cases of medical conflicts. There were totally 7 cases of medical conflicts only, which were 8 cases less compared to the cases reported between 2006 and 2009.The death toll decreased to 118 from 163 before the intervention. Conclusion: The establishment of standard clinical process flow and management mode can increase the early recognition ability of medical staff in emergency department, which can obviously decrease mortality and medical conflicts.