Treloar D J, Peterson E, Randall J, Lucid W
Division of Pediatric Emergency Medicine, Mount Carmel Hospital, Detroit, Michigan.
Ann Emerg Med. 1991 Mar;20(3):297-301. doi: 10.1016/s0196-0644(05)80944-8.
The objective of the study was to describe the use of emergency services by minors who are unaccompanied by their parents or guardians and how they are managed in emergency departments.
Self-administered survey.
The ED directors of 71 emergency medicine training programs, 82 Michigan community EDs, and 56 pediatric EDs.
One hundred eighteen (58%) surveys were returned. A median of five unaccompanied minors (range 0.2 to 150) were seen weekly by responding EDs. Pediatric EDs saw the most unaccompanied minors weekly (ten) compared with training programs (five) and community EDs (three) (P less than .01). Emergency medicine training programs had the greatest percentage (3.0%) of minors who were unaccompanied compared with pediatric EDs (2.2%) and community EDs (2.6%) (P less than .05). For all conditions surveyed, only 3.8% of patients would be refused medical care without parental consent. However, 36.8% of patients would have medical care delayed even for conditions that might be painful or harmful if left untreated for some time. Most EDs (85.5%) screen patients and treat those who are acutely ill, but some (11.1%) treat all regardless of severity.
Protocols should be developed for unaccompanied minors to ensure that delays in obtaining consent do not jeopardize the child and that the rights of minors for confidentiality and consent are recognized.
本研究的目的是描述父母或监护人不在身边的未成年人对急诊服务的使用情况，以及他们在急诊科是如何得到处理的。
自行管理的调查。
71个急诊医学培训项目的急诊科主任、82家密歇根社区急诊科以及56家儿科急诊科。
共回收118份（58%）调查问卷。回复的急诊科每周接诊的无人陪伴未成年人中位数为5名（范围为0.2至150名）。与培训项目（5名）和社区急诊科（3名）相比，儿科急诊科每周接诊的无人陪伴未成年人最多（10名）（P<0.01）。与儿科急诊科（2.2%）和社区急诊科（2.6%）相比，急诊医学培训项目中无人陪伴未成年人的比例最高（3.0%）（P<0.05）。在所有调查的病情中，只有3.8%的患者在没有父母同意的情况下会被拒绝治疗。然而，36.8%的患者即使是对于一些如果不及时治疗可能会疼痛或有害的病情，其治疗也会被推迟。大多数急诊科（85.5%）会对患者进行筛查并治疗急性病患者，但有些（11.1%）会对所有患者进行治疗，无论病情严重程度如何。
应为无人陪伴的未成年人制定协议，以确保在获得同意方面的延迟不会危及儿童，并确保未成年人的保密和同意权得到认可。
