Riley Hospital for Children, Indiana University Health, Indianapolis, IN.
Am J Health Syst Pharm. 2019 Sep 16;76(19):1532-1543. doi: 10.1093/ajhp/zxz167.
The purpose of this review article is to discuss considerations for the critically ill child presenting to an emergency department (ED) with pharmacists who have minimal to no pediatric training.
In 2015, 17% of all children visited an ED, constituting 30 million visits. The majority of these children were treated at community hospitals where pediatric care resources, including a pediatric-trained pharmacist, may be limited. Because of the complex array of ages and disease states, the care of critically ill children in the ED creates many concerns for adult and community hospitals. This article will focus on several common disease states seen in the pediatric ED, including septic shock, trauma, status epilepticus, and diabetic ketoacidosis.
Critically ill children admitted to a community or adult ED provide therapeutic dilemmas and medication safety concerns. A pharmacist with training or experience in pediatrics can have a major impact in patient outcomes in many of the disease states seen in these pediatric patients. This article highlights several key differences between critically ill pediatric and adult patients to better prepare all pharmacists to care for these vulnerable patients.
本文旨在讨论在急诊部门(ED)为几乎没有或没有儿科培训的药剂师治疗危重症儿童时需要考虑的问题。
2015 年,所有儿童中有 17%到 ED 就诊,构成 3000 万次就诊。这些孩子中的大多数在社区医院接受治疗,而社区医院的儿科医疗资源(包括接受过儿科培训的药剂师)可能有限。由于年龄和疾病状态的复杂组合,ED 中危重症儿童的护理给成人和社区医院带来了许多问题。本文将重点介绍儿科 ED 中常见的几种疾病状态,包括脓毒性休克、创伤、癫痫持续状态和糖尿病酮症酸中毒。
收入社区或成人 ED 的危重症儿童带来了治疗上的困境和药物安全问题。具有儿科培训或经验的药剂师可以对许多儿科患者的疾病状态产生重大影响,从而改善患者的预后。本文重点介绍了危重症儿科和成人患者之间的几个关键差异,以帮助所有药剂师更好地为这些脆弱的患者提供护理。