Foltin G L
Department of Pediatric Emergency Medicine, Bellevue Hospital Center/New York University Medical Center, NY 10016, USA.
Pediatrics. 1995 Jul;96(1 Pt 2):174-9.
In order to be effective those wishing to improve emergency care of children in an urban environment must be aware of barriers as well as resources. Urban children are at high risk for requiring emergency care as a result of both illness and injury. These children face a dangerous environment resulting from the problems of poverty, homelessness, overcrowded living conditions, drug abuse, and a shrinking tax base. They face this nation's highest rates of violent injury (intentional and unintentional), immunization delays, and preventable infectious diseases such as TB and measles. In addition, they have poor access to quality primary health care and suffer the greatest morbidity rates from chronic diseases such as asthma and diabetes. On the other hand, there is great opportunity to ensure that urban children receive quality emergency health care. The urban environment is rich in "centers of pediatric excellence," which often have paid full-time EMS systems in operation, and is the locale in which the majority of pediatric emergency medicine specialists and prehospital advanced life support providers practice. The child advocate must work to ensure that the urban child can benefit from these resources.
为了使措施有效，那些希望改善城市环境中儿童急救护理的人必须了解障碍和资源。由于疾病和受伤，城市儿童急需急救护理。这些儿童面临着由贫困、无家可归、居住条件拥挤、药物滥用以及税收基础缩减等问题导致的危险环境。他们面临着全国最高的暴力伤害率（有意和无意的）、免疫接种延迟以及可预防的传染病，如结核病和麻疹。此外，他们难以获得优质的初级卫生保健，并且患哮喘和糖尿病等慢性病的发病率最高。另一方面，确保城市儿童获得优质的紧急医疗护理有很大的机会。城市环境中有丰富的“儿科卓越中心”，这些中心通常有全职的急救医疗服务系统在运行，并且是大多数儿科急诊医学专家和院前高级生命支持提供者执业的地方。儿童权益倡导者必须努力确保城市儿童能够从这些资源中受益。
