Guglia E, Marchi A G, Messi G, Renier S, Gaeta G, Canciani M, Canciani G, Pizzul M G
Servizio di Pronto Soccorso e Primo Accoglimento, IRCCS Istituto per l'infanzia, Trieste.
Minerva Pediatr. 1995 Dec;47(12):533-9.
Temporary observation is a very short stay in Emergency Department, widely carried out in adult patients in our Country. No experience in childhood has been reported. In our emergency department children under 16 with acute diseases are admitted for 24-48 hours. From 1991 we carried out also temporary observation. Its effectiveness has been evaluated by studying our activity in 1992 (14.574 emergency room visits, with 664 admissions to our Department and 274 temporary observation) and 1993 (12820 emergency room visits, 573 admissions, 428 temporary observation). Compared to 1992, in 1993 there was a decrease of both emergency room visits (higher than expected from demographic lowering and in part due to payment for emergency room visits) and hospital admissions, and an increase of temporary observation. The stay in hospital was less than 6 hours in 94.2% of temporary observation patients. 18.2% of them were evaluated on clinical basis, 57% also by diagnostic examinations, 24.8% had some treatment. The 89% of the children were sent home following temporary observation, the others were admitted. Criteria for temporary observation were fairly similar to those for hospital admission, but not far as Central Nervous System and Renal Disease are concerned. Our study confirms the usefulness of temporary observation in childhood to reduce both the number of hospital admissions and the discomfort of the patient and his family. Nevertheless there is a need of criteria of appropriateness. Therefore we have elaborated guide lines for temporary observation and admission to our Department.
临时观察是在急诊科的短暂停留，在我国成年患者中广泛开展。目前尚无儿童相关经验的报道。在我们的急诊科，16岁以下的急性病患儿会住院24至48小时。自1991年起，我们也开展了临时观察。通过研究我们在1992年（14574次急诊就诊，其中664例收住我科，274例进行临时观察）和1993年（12820次急诊就诊，573例收住，428例临时观察）的工作情况，对其有效性进行了评估。与1992年相比，1993年急诊就诊次数（高于人口减少预期且部分归因于急诊就诊付费）和住院人数均有所下降，而临时观察人数增加。94.2%的临时观察患者住院时间少于6小时。其中18.2%仅根据临床评估，57%还进行了诊断检查，24.8%接受了某种治疗。89%的儿童在临时观察后被送回家，其余则被收住入院。临时观察的标准与住院标准相当相似，但在中枢神经系统疾病和肾脏疾病方面有所不同。我们的研究证实了儿童临时观察在减少住院人数以及患者及其家属不适方面的有用性。然而，需要合适的标准。因此，我们制定了本部门临时观察和入院的指导方针。
