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本文引用的文献

1
The association of emergency department crowding and time to antibiotics in febrile neonates.发热新生儿急诊拥挤与抗生素使用时间的关系。
Acad Emerg Med. 2011 Dec;18(12):1380-5. doi: 10.1111/j.1553-2712.2011.01221.x.
2
Emergency department crowding is associated with decreased quality of care for children.急诊科拥挤与儿童医疗质量下降有关。
Pediatr Emerg Care. 2011 Sep;27(9):837-45. doi: 10.1097/PEC.0b013e31822c1382.
3
Measures of crowding in the emergency department: a systematic review.急诊科拥挤度的测量：系统评价。
Acad Emerg Med. 2011 May;18(5):527-38. doi: 10.1111/j.1553-2712.2011.01054.x.
4
Timing of correct parenteral antibiotic initiation and outcomes from severe bacterial community-acquired pneumonia in children.儿童重症细菌性社区获得性肺炎的适当静脉用抗生素起始时机与结局。
Pediatr Infect Dis J. 2011 Apr;30(4):295-301. doi: 10.1097/INF.0b013e3181ff64ec.
5
Effect of a quality improvement intervention to decrease delays in antibiotic delivery in pediatric febrile neutropenia: a pilot study.质量改进干预对减少儿童发热性中性粒细胞减少症抗生素延迟给药的影响：一项试点研究。
J Crit Care. 2011 Feb;26(1):103.e9-12. doi: 10.1016/j.jcrc.2010.05.034. Epub 2010 Jul 8.
6
Antibiotics in sepsis and septic shock: like everything else in life, timing is everything.脓毒症和脓毒性休克中的抗生素：如同生活中的其他一切，时机至关重要。
Crit Care Med. 2010 Apr;38(4):1211-2. doi: 10.1097/CCM.0b013e3181d69db7.
7
Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department.在急诊科开始早期目标导向治疗的严重脓毒症或感染性休克患者中，抗生素使用时间对生存的影响。
Crit Care Med. 2010 Apr;38(4):1045-53. doi: 10.1097/CCM.0b013e3181cc4824.
8
Crowding delays treatment and lengthens emergency department length of stay, even among high-acuity patients.拥挤会延误治疗并延长急诊科留观时间，即使是在病情严重的患者中也是如此。
Ann Emerg Med. 2009 Oct;54(4):492-503.e4. doi: 10.1016/j.annemergmed.2009.03.006. Epub 2009 May 6.
9
Systematic review of emergency department crowding: causes, effects, and solutions.急诊科拥挤的系统评价：原因、影响及解决方案。
Ann Emerg Med. 2008 Aug;52(2):126-36. doi: 10.1016/j.annemergmed.2008.03.014. Epub 2008 Apr 23.
10
Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.拯救脓毒症运动：严重脓毒症和脓毒性休克治疗国际指南：2008年版
Crit Care Med. 2008 Jan;36(1):296-327. doi: 10.1097/01.CCM.0000298158.12101.41.

急诊部门拥挤与发热婴儿抗生素给药时间。

Emergency department crowding and time to antibiotic administration in febrile infants.

机构信息

University of Florida, College of Medicine, Department of Emergency Medicine Gainesville, Florida.

出版信息

West J Emerg Med. 2013 Sep;14(5):518-24. doi: 10.5811/westjem.2013.1.14693.

DOI:10.5811/westjem.2013.1.14693
PMID:24106552
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3789918/
Abstract

INTRODUCTION

Early antibiotic administration is recommended in newborns presenting with febrile illness to emergency departments (ED) to avert the sequelae of serious bacterial infection. Although ED crowding has been associated with delays in antibiotic administration in a dedicated pediatric ED, the majority of children that receive emergency medical care in the United States present to EDs that treat both adult and pediatric emergencies. The purpose of this study was to examine the relationship between time to antibiotic administration in febrile newborns and crowding in a general ED serving both an adult and pediatric population.

METHODS

We conducted a retrospective chart review of 159 newborns presenting to a general ED between 2005 and 2011 and analyzed the association between time to antibiotic administration and ED occupancy rate at the time of, prior to, and following infant presentation to the ED.

RESULTS

We observed delayed and variable time to antibiotic administration and found no association between time to antibiotic administration and occupancy rate prior to, at the time of, or following infant presentation (p>0.05). ED time to antibiotic administration was not associated with hospital length of stay, and there was no inpatient mortality.

CONCLUSION

Delayed and highly variable time to antibiotic treatment in febrile newborns was common but unrelated to ED crowding in the general ED study site. Guidelines for time to antibiotic administration in this population may reduce variability in ED practice patterns.

摘要

简介

建议在有发热症状的新生儿到急诊部（ED）就诊时尽早使用抗生素，以避免严重细菌感染的后遗症。尽管在专门的儿科 ED 中，ED 拥挤与抗生素给药延迟有关，但在美国接受紧急医疗护理的大多数儿童都到同时治疗成人和儿科急症的 ED 就诊。本研究的目的是研究在同时治疗成人和儿科急症的普通 ED 中，发热新生儿抗生素给药时间与拥挤之间的关系。

方法

我们对 2005 年至 2011 年间在普通 ED 就诊的 159 名新生儿进行了回顾性图表审查，并分析了抗生素给药时间与 ED 入住率在婴儿就诊前、就诊时和就诊后之间的关系。

结果

我们观察到抗生素给药时间延迟且变化较大，但未发现抗生素给药时间与婴儿就诊前、就诊时或就诊后入住率之间存在关联（p>0.05）。ED 抗生素给药时间与住院时间长短无关，也没有住院患者死亡。

结论

在普通 ED 研究现场，发热新生儿抗生素治疗时间延迟且高度可变，但与 ED 拥挤无关。该人群抗生素给药时间的指南可能会减少 ED 实践模式的变异性。