Children of the night.
Children of the night.
复制标题
夜晚的孩子们。
DOI：
10.1093/milmed/147.5.384
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发表时间：
2018
影响因子：
1.2
通讯作者：
Paul H. Ratner
中科院分区：
文献类型：
--
作者：
Linda Ornelas Wilson;Luis Canales;Frank P. Wilson;Paul H. Ratner
布鲁克陆军医疗中心是德克萨斯州圣安东尼奥的一家拥有610张床位的陆军教学医院。儿科每年约有60,000名患者就诊。在这些就诊中，约有10%是由未经预约的病人来的。这些患者每天8时至22时在儿科急性医疗疾病诊所(PAMIC)就诊。在布鲁克陆军医疗中心的主急诊室(ER)可以看到所有在夜班(2200小时至0800小时)期间进行无预约护理的儿童。这两家机构都使用了高度可重复性的、算法指导的分诊系统，利用非专业人员记录生命体征和某些主要症状，分诊算法根据该系统提供逐步说明，以确定为特定疾病分配的护理紧急类别。在这个先前描述的儿科分诊系统中。首先使用初始筛查算法对所有患者进行筛查。在该“初始筛查”中确定的任何患者都会立即引起医生的注意。医生必须毫不拖延地评估这些患者的护理紧急需求。未在初始筛查中确定的其余患者由36个主诉算法中的一个或多个进行分诊，以确定每个患者的护理紧急需求。两个机构都使用标准的分诊单来记录每一次相遇。如果多个护理紧急类别被分配给一个患者，则仅
MethodsBrooke Army Medical Center is a 610-bed Army Teaching Hospital in San Antonio, Texas. The Department of Pediatrics has approximately 60,000 patient visits per year. Approximately SO per cent of these visits are due to walk-in patients. These patients are seen on a daily basis between 0800 hours and 2200 hours in the Pediatric Acute Medical Illness Clinic (PAMIC). All children presenting for walk-in care during the night shift (2200 hours to 0800 hours) are seen in the Main Emergency Room (ER) at Brooke Army Medical Center.Both facilities used a highly reproducible, algorithm-directed triage system utilizing non-professionals to record vital signs and certain chief complaints, from which the triage algorithms provide step-by-step instructions for determining the care urgency category to be assigned for a specific complaint. In this previously described pediatric triage systern." all patients are first screened with the Initial Screen Algorithm. Any patient identified in this" Initial Screen" is immediately brought to the attention of a physician. The Physician must evaluate the care urgency needs of these patients without delay. The remainder of the patients not identified in the Initial Screen are triaged by one or more of 36 chief complaint algorithms to determine the care urgency needs of each patient. A standard triage slip is used in both facilities to record each encounter. In cases where multiple care urgency categories are assigned to one patient, only