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门急诊患儿危重症的评估现状和思考OA

Current status and considerations of the assessment of pediatric critical conditions in outpatient and emergency departments

中文摘要英文摘要

门急诊作为儿科急危重症救治的起始环节,其评估效能直接影响患儿预后.当前,儿科诊疗环境负荷高、患儿病理生理代偿有限且病情变化迅速、起病隐匿,给早期精准评估带来客观挑战.笔者认为,门急诊评估并非孤立的院内行为,而应被视为贯穿院前处置、专业转运至院内接诊的连续思维链条.尽管我国儿科急救体系建设取得长足进步,但院前与院内在评估视角的统一性、动态监测的连续性等方面仍有协同空间.文章通过分析门急诊评估现状,探讨如何强化以"生理功能"为核心的临床思维,强调动态复评在识别隐匿性危重症中的决策价值,力求提升医护人员的风险预判能力与思维深度,从而优化急诊决策,为构建更具韧性的儿科急救链条提供思路借鉴.

As the initial site of care for pediatric emergencies and critical illness,the outpatient and emergency department plays a decisive role in patient outcomes,with assessment performance directly influencing prognosis.In high-demand clinical settings,the combination of insidious disease onset and limited physiological reserve in children complicates early risk recognition.Emergency assessment should therefore be conceptualized as a continuous process spanning prehospital management,transport,and in-hospital evaluation rather than an isolated in-hospital task.Despite substantial progress in pediatric emergency system development,further integration between prehospital and in-hospital assessment-particularly in unified risk frameworks and continuity of dynamic monitoring-is warranted.This paper reviews current practices and emphasizes physiology-centered clinical reasoning and dynamic reassessment as key strategies for detecting occult critical illness,with the goal of strengthening anticipatory risk appraisal and enhancing the resilience of the pediatric emergency care continuum.

颜景礼;许巍

国家儿童医疗中心 中国医科大学附属盛京医院儿童急诊与重症医学科,辽宁沈阳 110004国家儿童医疗中心 中国医科大学附属盛京医院儿童急诊与重症医学科,辽宁沈阳 110004

医药卫生

儿童危重症早期识别动态复评院前-院内衔接

pediatric critical illnessearly recognitiondynamic reassessmentpre-hospital and hospital linkage

《中国实用儿科杂志》 2026 (6)

474-479,510,7

国家自然科学基金项目(82470042)

10.19538/j.ek2026060604

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