Wakosa Adeline, Roussel Aude, Delaplace Marion, Le Bidre Emmanuelle, Binois Raphaëlle, Valéry Antoine, Bens Guido, Estève Eric
Centre hospitalier régional d'Orléans, service de dermatologie, 45000 Orléans, France.
Presse Med. 2013 Dec;42(12):e409-15. doi: 10.1016/j.lpm.2013.07.017. Epub 2013 Nov 8.
Dermatologists, both as hospital and as resident practitioners, are often requested to see emergencies of their discipline, although appointment planning are already fully booked months in advance. Orleans Regional Hospital (ORH) has opened a department of dermatological emergency consultation to try to help with this issue. A prospective, descriptive and consecutive study on patient characteristics was conducted during its first year operating.
In September 2011, we opened a department of dermatological emergency consultation. Reception is skin disorders evaluated by physicians or nurses as "emergencies", according to predefined criteria. Follow-up visits are performed in the afternoon.
Within one year, 2209 medical visits were conducted, with an average of 8,7 emergency visits per day. The maximum numbers of patients treated by our dermatological emergency unit in one single morning was 19. Mondays were the busiest day of the week. The average age of a patient attending the department was 33 years, with 29% of pediatric patients (under 15 years old). The majority of patients presented spontaneously (43%), or were referred by general practitioners (25%). Adult and pediatric emergency departments sent 8% of patients. The two main reasons for consultation were rash (48%) and pruritus (16%). Diagnoses observed were mainly infections (24%) and eczema (14%). Scabies accounted for 9% of all diagnoses. In the aftermath of an emergency dermatological consultation, 84 patients were hospitalized, including 74 in the dermatology department of Orleans hospital totalling 505 days of hospitalization.
The value of a dermatological emergency consultation is well demonstrated in areas where more medical services are available (such as cities with University hospitals available). It is even more justified in areas with a deficit of healthcare service availability such as Central France.
皮肤科医生,无论是在医院工作还是作为住院医生,尽管预约计划已经提前数月就被排满,但仍经常被要求处理本专业的紧急情况。奥尔良地区医院(ORH)开设了皮肤科急诊咨询部门,试图解决这一问题。在其运营的第一年对患者特征进行了一项前瞻性、描述性和连续性研究。
2011年9月,我们开设了皮肤科急诊咨询部门。接收的是经医生或护士根据预定义标准评估为“紧急情况”的皮肤疾病。下午进行随访。
在一年时间里,共进行了2209次就诊,平均每天有8.7次急诊就诊。我们皮肤科急诊单元在一个上午治疗的患者最多数量为19名。周一为一周中最繁忙的日子。到该科室就诊患者的平均年龄为33岁,其中29%为儿科患者(15岁以下)。大多数患者是自行前来就诊(43%),或者由全科医生转诊(25%)。成人和儿科急诊科转诊了8%的患者。就诊的两个主要原因是皮疹(48%)和瘙痒(16%)。观察到的诊断主要为感染(24%)和湿疹(14%)。疥疮占所有诊断的9%。在皮肤科急诊咨询之后,84名患者住院,其中74名在奥尔良医院皮肤科,住院总天数达505天。
皮肤科急诊咨询的价值在医疗服务更丰富的地区(如设有大学医院的城市)得到了充分体现。在医疗服务供应不足的地区,如法国中部地区,其合理性更为凸显。