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THE ESTABLISHMENT OF PEDIATRIC EMERGENCY SERVICE TO CRITICAL CHILDREN

Lu, X.W.

Shanghai Children’s Medical Center, Shanghai, China

Objective: High population density and heavy traffic in Shanghai create a great burden for hospital emergency service. Most hospitals treat pediatric emergency cases in adult’s emergency room. In addition, some children in critical condition are sent to the intensive care unit first for resuscitation rather than being stabilized in the emergency room. Resuscitation time is delayed and critical ill children have to suffer more physiological instability in above situation. Therefore, the objective of this paper is to present the establishment of pediatric emergency service and its effect on pediatric emergency care in Shanghai Children’s Medical Center.

Methods: The pediatric emergency service was established in following steps. First, hospital emergency calling system is established by using a unified number “ 9999”. A total of six bibbers that are used for emergency service only are distributed to emergency attending physician, on-call pediatric attending physician, medical chief resident, surgical chief resident, anesthesiologists, and nursing leader of pediatric intensive care unit. All participated medical and nursing staffs were certified by Pediatric Advanced Life Support examination. Third, cases training sections were conducted to ensure the quality of emergency service.

Results: The emergency green pathway was established in February, 2000. A total of 40 critical ill patients were treated in the emergency room. 39 cases were successfully resuscitated and the successful rate was 97.5%. Among resuscitated cases, two cases received intraosseous cannulation for emergency medication and fluid administration.

Conclusions: The process of pediatric emergency service can be a model for treating urgent pediatric patient. In future, the coordination of emergency auxiliary services, such as radiology and laboratory examination has to be improved to ensure the quality of service. It is important to have a coordinated emergency service to eliminate the obstacles of receiving prompt medical service. Shanghai Children’s Medical Center will continue to practice on this emergency service model to all needed children and family.