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儿科转运回顾性研究:转运后我们的患者去向何方?

Retrospective Review of Pediatric Transport: Where Do Our Patients Go After Transport?

作者信息

Krennerich Emily, Sitler Curtis G, Shah Manish, Lam Fong, Graf Jeanine

机构信息

Department of Pediatric Critical Care, Texas Children's Hospital, Houston, TX; Baylor College of Medicine, Houston, TX.

Department of Pediatric Critical Care, Texas Children's Hospital, Houston, TX.

出版信息

Air Med J. 2017 Nov-Dec;36(6):332-338. doi: 10.1016/j.amj.2017.06.006. Epub 2017 Aug 12.

Abstract

OBJECTIVE

This review describes disposition of transported children and identifies contributing factors affecting optimal patient placement. The study describes timing and patient placement indicators in transport patients to identify areas of improvement, re-education, and training.

METHODS

A retrospective chart review for transports via our pediatric specialty transport team from January 1, 2012, to December 31, 2014, was performed. Patients were identified by the transport quality assurance performance improvement database, hospital electronic medical records, and transport medical records.

RESULTS

Three thousand two hundred fifty-six pediatric patient transports were reviewed. One hundred forty-three records were excluded. Of the remaining 3,113 patients, admission disposition was: 1,487 (47%) pediatric intensive care unit, 120 (4%) pediatric cardiovascular intensive care unit, 835 (27%) step-down critical care unit, 438 (14%) emergency department, 194 (6%) general floor, 29 (1%) neonatal intensive care unit, and 10 (< 1%) operating room. Of the 22% transported to a lower-acuity unit, several subsequently required critical care. Children transported for traumatic injuries had a shorter emergency department length of stay than medical patients.

CONCLUSION

Our study validates the efficient use of pediatric specialty transport team resources. Many transported patients are critically ill, require specialized pediatric services, or require definitive pediatric emergency department care.

摘要

目的

本综述描述了转运儿童的处置情况,并确定了影响患者最佳安置的相关因素。该研究描述了转运患者的时间安排和患者安置指标,以确定需要改进、再教育和培训的领域。

方法

对2012年1月1日至2014年12月31日期间通过我们的儿科专科转运团队进行的转运进行回顾性病历审查。通过转运质量保证绩效改进数据库、医院电子病历和转运病历识别患者。

结果

共审查了3256例儿科患者转运记录。排除了143份记录。在其余3113例患者中,入院处置情况为:1487例(47%)入住儿科重症监护病房,120例(4%)入住儿科心血管重症监护病房,835例(27%)入住逐步降级重症监护病房,438例(14%)入住急诊科,194例(6%)入住普通病房,29例(1%)入住新生儿重症监护病房,10例(<1%)入住手术室。在转运至低级别病房的22%的患者中,有几例随后需要重症监护。因创伤性损伤而转运的儿童在急诊科的住院时间比内科患者短。

结论

我们的研究证实了儿科专科转运团队资源的有效利用。许多转运患者病情危重,需要专门的儿科服务,或需要明确的儿科急诊科护理。

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