儿科急诊拥挤的现况分析和解决策略研究进展  

Research progress on situations and solutions of pediatric emergency department overcrowding

作　　者：吴宇涵 项龙[1,3] Wu Yuhan;Xiang Long(Department of Emergency Intensive Care Unit,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China;School of Pediatrics,School of Medicine,Shanghai Jiaotong University,Shanghai 200025,China;Department of Pediatric Critical Care Medicine,Shanghai Children′s Medical Center,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心EICU,200127 [2]上海交通大学医学院儿科学院,200025 [3]上海交通大学医学院附属上海儿童医学中心重症医学科,200127

出　　处：《中国小儿急救医学》2024年第8期619-622,共4页Chinese Pediatric Emergency Medicine

基　　金：上海高水平地方高校创新团队(SHSMU-ZDCX20212800)。

摘　　要：急诊拥挤是急诊医疗需求超过急诊可用资源的状况,国内外均面临儿科急诊拥挤的问题。儿科急诊拥挤不仅危及患儿急救,也严重降低患儿及家属的就医体验,并且增加医护人员压力。儿科急诊拥挤的形成与输入、处置、输出环节有关。患儿父母过度焦虑、社区医疗资源不足等可能导致急诊输入量增加;急诊空间、人员、设备、流程等影响急诊诊治效率;待入院患儿滞留、急诊输出受阻等输出环节是导致急诊拥挤的关键原因。针对上述三个环节,儿科急诊拥挤解决策略包括增强急诊以外的医疗资源建设、优化急诊诊疗流程及相关配置、及时收治待入院患儿等。此外,构建儿科急诊拥挤监测或预警模型、发展依托人工智能的智慧医疗服务也是缓解儿科急诊拥挤的新思路。本文对国内外儿科急诊拥挤的相关研究进行综述,旨在为缓解儿科急诊拥挤提供参考。Emergency department(ED)crowding refers to a situation where the demand for emergency care exceeds available resources,and it is a problem faced by both domestic and international pediatric ED.Pediatric ED crowding not only threatens the health of children but also diminishes the healthcare experience for both children and their families,while increasing the stress of healthcare personnel.The formation of pediatric ED crowding is related to input,throughput and output.Factors such as excessive parental anxiety and insufficient community healthcare resources,may add to ED input;The efficiency of diagnosing and treating pediatric emergency patients can be influenced by space,personnel,equipment,and processes in ED;Key reason for pediatric ED crowding is the backlog of patients awaiting admission which impedes output.Concerning the three stages above,solutions of pediatric ED crowding could include enhancing non-emergency medical resources,optimizing diagnosis and treatment process and related configuration in ED,and promptly admitting patients awaiting hospitalization.Additionally,constructing pediatric ED crowding prediction models and developing intelligent healthcare based on artificial intelligence are also avenues for alleviating pediatric ED crowding.This review provided an overview of relevant domestic and international research on pediatric ED crowding,aiming to offer new ideas for mitigation of pediatric ED crowding.

关 键 词：儿科急诊 拥挤 急诊管理 急诊照顾 儿科评估分诊 

分 类 号：R720.597[医药卫生—急诊医学]