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小儿桡骨远端骨折手法整复:手术时间的多中心分析

Paediatric distal radial fracture manipulation: multicentre analysis of process times.

作者信息

Mitchell L, Archer E, Middleton S, Maclean A, Jones L, Benger J, Lloyd G

机构信息

Emergency Department, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter EX2 5DW, UK.

出版信息

Emerg Med J. 2009 Jan;26(1):41-2. doi: 10.1136/emj.2007.057208.

Abstract

BACKGROUND

Children with simple radial fractures requiring manipulation are conventionally admitted for manipulation under general anaesthesia. On the assumption that children (and their parents) wish to spend as little time in hospital as possible, a study was undertaken to explore the experience of children with distal radial fractures admitted for general anaesthesia.

METHODS

A retrospective analysis was performed of the time taken from arrival at the emergency department (ED) to general anaesthesia and the time taken from arrival at the ED to hospital discharge in three centres in south-west England: the Bristol Children's Hospital, Derriford (Plymouth) Hospital and the Royal Devon & Exeter Hospital.

RESULTS

The median wait for general anaesthesia was >8 h and the median wait from ED admission to discharge was >21 h. This compares with a typical arrival to discharge time for paediatric procedural sedation of 4-5 h in the ED of the Royal Devon & Exeter Hospital.

CONCLUSIONS

Given the assumption that children (and their parents) wish to spend as little time in hospital as possible, there appears to be a role for procedural sedation in the ED for this group of children, with a significantly reduced turnaround time anticipated.

摘要

背景

单纯桡骨骨折需要手法复位的儿童通常会住院接受全身麻醉下的手法复位。基于儿童(及其父母)希望尽可能减少住院时间这一假设,开展了一项研究,以探究因接受全身麻醉而住院的桡骨远端骨折儿童的经历。

方法

对英格兰西南部三个中心(布里斯托尔儿童医院、德里福德(普利茅斯)医院和皇家德文郡埃克塞特医院)从到达急诊科到接受全身麻醉的时间以及从到达急诊科到出院的时间进行了回顾性分析。

结果

全身麻醉的中位等待时间超过8小时,从急诊科入院到出院的中位等待时间超过21小时。相比之下,皇家德文郡埃克塞特医院急诊科小儿程序性镇静的典型入院到出院时间为4 - 5小时。

结论

鉴于儿童(及其父母)希望尽可能减少住院时间这一假设,对于这类儿童,在急诊科进行程序性镇静似乎可行,预计周转时间将显著缩短。

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