Mace Sharon E, Bern Andrew I
Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.
Am J Emerg Med. 2007 Sep;25(7):762-9. doi: 10.1016/j.ajem.2006.12.011.
Pediatric patients are likely victims in a disaster and are more vulnerable in a disaster than adults, yet they have been essentially overlooked in disaster management according to the Pediatric Institute of Medicine Report. We did a needs assessment of Disaster Medical Assistance Teams regarding pediatric issues. Results were as follows: pediatric patients comprise a significant percentage of disaster victims (up to 85% in one disaster), and deficiencies were noted in the curriculum/training/resources. The percentage of time pediatric topics were missing from the curriculum was as follows: airway, 16%; trauma, 33%; disaster triage, 36%; burns, 42%; pain management, 42%; mental health, 45%; patient scenarios, 45%. The percentage of time pediatric equipment was missing was as follows: airway, 16%; intravenous lines, 37%; cervical collars, 38%; medicines, 38%; Broselow tape, 46%; backboards, 62%. Pediatric patients were included in disaster drills 63% of the time. Only 33% had pediatric protocols other than JumpSTART. A need to improve the pediatric components of Disaster Medical Assistance Teams was identified.
儿科患者很可能成为灾难中的受害者,而且在灾难中比成年人更脆弱,但根据美国国家医学院的报告,在灾难管理中他们基本上被忽视了。我们针对灾难医疗援助队的儿科问题进行了一次需求评估。结果如下:儿科患者在灾难受害者中占相当大的比例(在一次灾难中高达85%),并且在课程/培训/资源方面存在不足。课程中缺失儿科主题的时间百分比如下:气道管理,16%;创伤,33%;灾难分诊,36%;烧伤,42%;疼痛管理,42%;心理健康,45%;患者模拟场景,45%。缺失儿科设备的时间百分比如下:气道管理设备,16%;静脉输液管,37%;颈托,38%;药品,38%; Broselow测量带,46%;背板,62%。灾难演练中有63%的时间纳入了儿科患者。只有33%的灾难医疗援助队除了《儿童快速评估与分类程序》(JumpSTART)外还有儿科预案。已确定有必要改进灾难医疗援助队的儿科相关内容。