从急诊部进行儿科外科咨询的适当性:一项两中心研究
Aybegum Kalyoncu Aycenk1, Gul Salci2
1Department of Pediatric Surgery, Faculty of Medicine, Ordu University, Ordu, Turkey.
概括
从急诊室的儿科手术咨询往往是不合适的,特别是在晚上. 改善分拣和培训对于减少医生工作量和提高儿科手术效率至关重要.
科学领域:
- 儿科手术 儿科手术
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
背景情况:
- 儿科急诊室 (PED) 的患者数量增加导致更多的咨询,耗费资源并导致效率低下.
- 儿科手术 (PS) 面临着全球的短缺,加剧了不必要的咨询的影响.
- 本研究解决了需要评估PED对PS咨询和相关工作负载的适当性.
研究的目的:
- 为了确定来自儿科急诊室的儿科手术咨询的真实指示率.
- 量化这些咨询给儿科外科部门带来的工作负担.
- 确定影响咨询适当性的因素,例如请求时间.
主要方法:
- 对1639名儿科患者的回顾性分析,这些患者在2023年在两所大学三级医院从PED转移到PS.
- 收集的数据包括患者人口统计,咨询时间,初步诊断和结果.
- 咨询按理由和时间分类;统计分析使用SPSS v25.0 (P<0.05显著性).
主要成果:
- 在52,660名PED患者中,1639名 (3.1%) 接受了PS咨询.
- 49%的咨询被认为是适当的,而51%的咨询仅被推用于儿科评估.
- 夜间咨询显著更有可能是不合适的 (P<.00001);常见的原因包括腹痛/尾炎 (43.3%),外体摄入 (9.6%),和创伤 (7.1%).
结论:
- 发现PED的不适当儿科手术咨询率很高,特别是在夜间.
- 显然需要改进分选方案,并在PED内部加强培训,以优化咨询的适当性.
- 解决这些效率不足对于提高临床效率和减轻儿科外科医生的工作负担至关重要.
相关概念视频
01:26Kidney Transplant II: Surgical Procedure
279
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
279
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
194
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
194
01:29Drug Dosing: Infants and Children
231
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
231
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
229
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
229