Pediatric Critical Care Telemedicine Program: A Single Institution Review.
Pediatric Critical Care Telemedicine Program: A Single Institution Review.
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儿科重症监护远程医疗计划：单一机构审查。
DOI：
10.1089/tmj.2015.0043
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Marcin,JamesP
中科院分区：
文献类型：
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作者：
Hernandez,Maria;Hojman,Nayla;Sadorra,Candace;Dharmar,Madan;Nesbitt,ThomasS;Litman,Rebecca;Marcin,JamesP
背景：尽管获得儿科专业知识的机会有限，但农村和社区急诊科（ED）经常接收和治疗重症儿童。越来越多地，儿科重症监护计划在儿童医院正在使用远程医疗提供咨询，以这些ED的目标，提高质量的carrying.Materials和方法：我们进行了回顾性分析，在一个单一的大学儿童医院的儿科重症监护远程医疗计划。2000年至2014年间，我们审查了为农村和社区急诊室儿童提供的所有远程医疗咨询，使用一组全面的基于证据的主要投诉对就诊进行分类，并报告了咨询对患者处置的影响。我们还审查了儿科艾德访问的总数，以计算与远程医疗consultationwerenews.Results的相对频率：在研究期间，有308个咨询提供给急性病和/或受伤的儿童的各种主要投诉，最常见的呼吸系统疾病，急性损伤和神经系统疾病。自成立以来，咨询次数一直在增加，参与的执行主任人数也在增加（n=18）。对8.6%的重病儿童进行了远程医疗咨询，其中大多数导致接收医院入院（n=150，49%），少数患者需要送往大学儿童医院（n=103，33%）。这个单一的机构，大学儿童医院-基于审查表明，儿科重症监护远程医疗计划用于为农村和社区ED的重病儿童提供咨询，可行的，可持续的，并且相对不经常使用，最典型的是用于病情最严重的儿科患者。
Background:Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care.Materials and Methods:We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided.Results:During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n=18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n=150, 49%), with a minority of patients requiring transport to the university children's hospital (n=103, 33%).Conclusions:This single institutional, university children's hospital–based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.