Klig Jean E, O'Malley Patricia J
Department of Pediatric Emergency Medicine, Boston Medical Center, 91 East Concord Street, Boston, MA 02118, USA.
Curr Opin Pediatr. 2007 Oct;19(5):591-6. doi: 10.1097/MOP.0b013e3282efd4cc.
An emergency in the office setting can be problematic without adequate staff, support, tools, and protocols. Though many emergencies are not immediately life-threatening, one risks the 'worst case scenario' occurring if not adequately prepared. Pediatric patients are prone to respiratory distress and compromise in many emergencies, and can rapidly decompensate without adequate support. A review of the history of emergency medical services for children and the framework for office emergency preparedness offers insight into current challenges for primary care providers.
Research has demonstrated that many primary care offices and clinics are ill prepared to handle common pediatric emergencies. Reliance on the Emergency Medical Services system is insufficient to assure optimal outcomes, especially given variations in the equipment, training, and experience of Emergency Medical Services providers in the care of children, and in remote areas where access may be delayed. Preparation and practice for office emergencies through 'mock code' exercises can increase practitioner confidence and reduce anxiety to perform life-saving care.
Better outcomes for office emergencies can result from staff training, availability of appropriate equipment and medications, maintenance of skills via formal and informal practice, and pathways for expeditious transfer to a definitive care facility.
在办公场所，如果没有足够的人员、支持、工具和预案，紧急情况可能会成为难题。尽管许多紧急情况并非立即危及生命，但如果没有充分准备，就有可能出现“最坏的情况”。儿科患者在许多紧急情况下容易出现呼吸窘迫和功能障碍，若没有足够的支持，病情可能会迅速恶化。回顾儿童紧急医疗服务的历史以及办公场所应急准备的框架，有助于深入了解初级保健提供者当前面临的挑战。
研究表明，许多初级保健办公室和诊所应对常见儿科紧急情况的准备不足。仅仅依靠紧急医疗服务系统不足以确保获得最佳结果，特别是考虑到紧急医疗服务提供者在儿童护理方面的设备、培训和经验存在差异，以及在偏远地区可能会延迟获得服务。通过“模拟急救”演习对办公场所紧急情况进行准备和演练，可以增强从业者的信心，减少进行救生护理时的焦虑。
通过员工培训、提供适当的设备和药物、通过正式和非正式练习保持技能，以及建立迅速转诊至确定性治疗机构的途径，可以改善办公场所紧急情况的处理结果。
