Zhonghua Er Ke Za Zhi. 2014 Dec;52(12):913-7.
Pre-hospital care, emergency department and critical care medicine are the key components of emergency medical service system. Two investigations about the pediatric critical care medicine in China mainland showed great progress. In recent years, most hospitals in China mainland have established emergency department, hardware configuration and staff status were gradually standardized. But most of the emergency departments mainly provide service to adult patients and pediatric emergency medicine lags behind. The purpose of this investigation was to understand the current situation and main problems of pediatric emergency in China mainland.
A questionnaire developed by the Subspecialty Group of Pediatrics, Chinese Society of Emergency Medicine and the Subspecialty Group of Emergency Medicine, Chinese Society of Pediatrics was e-mailed to the members of the above-mentioned two subspecialty groups. The contents of the questionnaire included 46 items which were divided into 5 categories: the general situation of the hospital, the pediatric emergency setting and composition, key equipments and techniques, staff status, training program and running data from 2011 to 2012.
Sixty-three questionnaires were delivered and 27 (42.9%) hospitals responded which located in 15 different provinces, municipalities and autonomous regions. Among the 27 hospitals, 10 (37.0%) had no pediatric resuscitation room; 25 (92.6%) had no equipments for cardiac output monitor and gastric lavage; 13 (48.1%) had no bedside fibrolaryngoscope or fiberbronchoscope; 5 (18.5%) had no blood gas analyzer; 4 (14.8%) without respirator, defibrillator, bedside radiography or ultrasonic equipment; 2 (7.4%) had no neonatal incubator; 9 (33.3%) could not do intraossous infusion. The average ratio of professional emergency pediatricians to all physicians was 43.5%. Twenty hospitals incompletely filled in the pediatric emergency running data.
The main problems existing in pediatric emergency include: imperfect pediatric emergency settings; short of key equipment; key rescue techniques are not popularized, acute shortage of emergency pediatricians and inadequate monitoring and management of pediatric emergency. The major ways to solve the predicament in pediatric emergency should include: the policy and financial support from national and local government; training pediatricians, especially urgent training of emergency pediatricians; improving pediatric emergency development and management.
院前急救、急诊科及重症医学是急诊医疗服务体系的关键组成部分。中国大陆两项关于儿童重症医学的调查显示取得了巨大进展。近年来，中国大陆大多数医院都设立了急诊科，硬件配置和人员状况逐渐规范。但大多数急诊科主要为成年患者提供服务，儿童急诊医学相对滞后。本次调查的目的是了解中国大陆儿童急诊的现状及主要问题。
由中华医学会急诊医学分会儿科学组和中华医学会儿科学分会急诊医学学组制定的调查问卷通过电子邮件发送给上述两个学组的成员。问卷内容包括46项，分为5类：医院概况、儿童急诊设置与组成、关键设备与技术、人员状况、培训项目以及2011年至2012年的运行数据。
共发放63份问卷，27家（42.9%）医院回复，这些医院分布在15个不同的省、直辖市和自治区。在这27家医院中，10家（37.0%）没有儿童复苏室；25家（92.6%）没有心输出量监测仪和洗胃设备；13家（48.1%）没有床边纤维喉镜或纤维支气管镜；5家（18.5%）没有血气分析仪；4家（14.8%）没有呼吸机、除颤器、床边放射摄影或超声设备；2家（7.4%）没有新生儿暖箱；9家（33.3%）不能进行骨内输液。专业儿童急诊医生与所有医生的平均比例为43.5%。20家医院未完整填写儿童急诊运行数据。
儿童急诊存在的主要问题包括：儿童急诊设置不完善；关键设备短缺；关键抢救技术未普及，儿童急诊医生严重短缺以及儿童急诊监测与管理不足。解决儿童急诊困境的主要途径应包括：国家和地方政府的政策和资金支持；培训儿科医生，尤其是紧急培训儿童急诊医生；促进儿童急诊发展与管理。
