Kula Roman, Popela Stanislav, Klučka Jozef, Charwátová Daniela, Djakow Jana, Štourač Petr
Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic.
Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic.
Children (Basel). 2023 Apr 17;10(4):741. doi: 10.3390/children10040741.
The increasing attendance of paediatric emergency departments has become a serious health issue. To reduce an elevated burden of medical errors, inevitably caused by a high level of stress exerted on emergency physicians, we propose potential areas for improvement in regular paediatric emergency departments. In an effort to guarantee the demanded quality of care to all incoming patients, the workflow in paediatric emergency departments should be sufficiently optimised. The key component remains to implement one of the validated paediatric triage systems upon the patient's arrival at the emergency department and fast-tracking patients with a low level of risk according to the triage system. To ensure the patient's safety, emergency physicians should follow issued guidelines. Cognitive aids, such as well-designed checklists, posters or flow charts, generally improve physicians' adherence to guidelines and should be available in every paediatric emergency department. To sharpen diagnostic accuracy, the use of ultrasound in a paediatric emergency department, according to ultrasound protocols, should be targeted to answer specific clinical questions. Combining all mentioned improvements might reduce the number of errors linked to overcrowding. The review serves not only as a blueprint for modernising paediatric emergency departments but also as a bin of useful literature which can be suitable in the paediatric emergency field.
儿科急诊科就诊人数的不断增加已成为一个严重的健康问题。为了减少因急诊医生承受的高度压力而不可避免地导致的医疗差错负担增加，我们提出了常规儿科急诊科可能的改进领域。为了确保为所有前来就诊的患者提供所需的护理质量，儿科急诊科的工作流程应得到充分优化。关键组成部分仍然是在患者到达急诊科时实施经过验证的儿科分诊系统之一，并根据分诊系统对低风险患者进行快速分流。为确保患者安全，急诊医生应遵循发布的指南。认知辅助工具，如设计良好的检查表、海报或流程图，通常会提高医生对指南的遵守情况，并且每个儿科急诊科都应配备。为了提高诊断准确性，根据超声检查方案，在儿科急诊科使用超声应旨在回答特定的临床问题。综合上述所有改进措施可能会减少与过度拥挤相关的差错数量。该综述不仅可作为儿科急诊科现代化的蓝图，还可作为适用于儿科急诊领域的有用文献库。
