事故与急救部门仍未能对哮喘严重程度进行评估。
Accident and emergency departments are still failing to assess asthma severity.
作者信息
Harvey S, Forbes L, Jarvis D, Price J, Burney P
机构信息
Intensive Care National Audit and Research Centre, London, UK.
出版信息
Emerg Med J. 2003 Jul;20(4):329-31. doi: 10.1136/emj.20.4.329.
OBJECTIVES
To quantify the documentation of vital signs in children attending accident and emergency (A&E) for asthma and to assess whether indicators of severity were used appropriately.
METHODS
Records of all children aged 3 to 14 attending A&E for the treatment of asthma in four London hospitals over a three month period were examined for documentation of heart rate, respiratory rate, peak expiratory flow rate, oxygen saturation, and fraction of inspired oxygen. The relation between severity indicators and whether the child was admitted or not was examined.
RESULTS
There were 255 attendances in 229 children. Heart rate, respiratory rate, and oxygen saturation were recorded on most attendances (94.5%, 85.5%, and 96.8%) but fraction of inspired oxygen and peak flow were recorded in few children (48.6% and 48.5%). Heart rate and respiratory rate were higher and oxygen saturation lower in children who were admitted compared with those who were not.
CONCLUSIONS
Assessment of airways obstruction is inadequate in children but when measured may be used appropriately to guide admission. There is a need for interventions to improve assessment of children attending A&E for asthma.
目的
量化因哮喘前往急诊部（A&E）就诊的儿童生命体征的记录情况，并评估严重程度指标是否得到恰当使用。
方法
对伦敦四家医院在三个月期间因哮喘接受治疗的所有3至14岁儿童的记录进行检查，查看心率、呼吸频率、呼气峰值流速、血氧饱和度和吸入氧分数的记录情况。研究严重程度指标与儿童是否入院之间的关系。
结果
229名儿童就诊255次。大多数就诊记录了心率、呼吸频率和血氧饱和度（分别为94.5%、85.5%和96.8%），但很少有儿童记录吸入氧分数和峰值流速（分别为48.6%和48.5%）。与未入院儿童相比，入院儿童的心率和呼吸频率更高，血氧饱和度更低。
结论
对儿童气道阻塞的评估不足，但测量时可恰当用于指导入院决策。需要采取干预措施来改善对因哮喘前往急诊部就诊儿童的评估。
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