Çocuk acil gözlem birimlerinin çocuk hastalar için kullanımı: Bir üniversite hastanesinin izlenimleri

Amaç: Sık görülen çocukluk çağı hastalıkları için yataklı servisler dışında bir seçenek olan acil gözlem birimlerinin nasıl kullanıldığını değerlendirmektir. Gereç ve Yöntem: Gazi Üniversitesi Tıp Fakültesi Çocuk Acil Servis’inde yer alan Çocuk Acil Gözlem Birimi’ne 1 Ocak-31 Aralık 2006 tarihleri arasında yatan olguların demografik özellikleri, tanıları, hastanede kalış süreleri acil servis hasta kayıt defterinden ve hasta dosyalarından elde edilen veriler doğrultusunda geriye dönük olarak incelendi. Bulgular: Bir yıl içinde Çocuk Acil Polikliniği’ne başvuran 22,286 olgudan, 919’u (%4,1) yataklı servislerde; yaşları 1-228 ay arasında değişen 243’ü kız, 292’si erkek 535 (%2,4) hasta ise Acil Gözlem Birimi’nde izlendi. Acil Gözlem Birimi’ne yatan hastaların yatış tanıları sırasıyla travma (164/535), zehirlenme (111/535), solunum sistemi hastalıkları (65/535) ve nörolojik hastalıklar (61/535) idi. Tüm olguların 494’ü yirmidört saatten kısa , 41’i yirmidört saatten daha uzun süre Acil Gözlem Birimi’nde izlendi. Olguların 439’u (%82) Çocuk Acil Gözlem Birimi’nden taburcu edilirken, 96 olgu izlem ve tedavilerin devamı için ilgili servislere devredildi. Çıkarımlar: Bir yıl içinde Acil Servis’ten yataklı servislere ve Acil Gözlem odalarına yatan hasta sayıları göz önüne alındığında, Acil Gözlem Birimi’nde izlenen 535 olgunun %82’sinin Acil Gözlem Birimi’nden taburcu edilmiş olması, yataklı servislere gereksiz hasta yatırılması ve gereksiz tetkik yapılmasını engellemede, hastanede kalış süresini azaltmada, klinik bulguları şüpheli olan olguların tanı ve tedavilerinin gecikmesini önlemede, hastanın daha çabuk taburcu edilerek hasta memnuniyetini arttırmada önemlidir. Bu nedenlerle, acil gözlem birimleri, çocuk hastaların belli durumlarda daha iyi değerlendirilmesini ve tedavilerinin yapılabilmesini sağlamak için çocuk acil servisleri içinde hastanelerin olanaklarına göre bulundurulması gereken alanlardır.

Usage of pediatric emergency department observation unit for children: Observations in a university hospital

Aim: The evaluation of pediatric emergency department observation unit for the hospitalization of patients with frequently seen childhood disorders, as an alternative to hospital wards. Material and Method: Demographic features, diagnoses, hospital stay intervals of patients hospitalized in Gazi University Faculty of Medicine Pediatric Emergency Department Observation Unit between January 1 st and November 31 st 2006 were collected from the Pediatric Emergency Department records and patient files. Results: Within one year, 22286 patients were admitted. Among them, 535 patients were hospitalized in The Pediatric Observation Unit while 919 patients were hospitalized in wards. A total of 535 patients (243 girls, 292 boys) aged between 1-228 months were hospitalized in the Pediatric Emergency Unit. Their diagnoses were trauma (164/535), intoxications (111/535), respiratory diseases (65/535) and neurologic diseases (61/535). Four-hundred-ninenty-four of all cases were hospitalized for less than 24 hours, 41 of them stayed more than 24 hours at the Observation Unit. 439 (82%) of all cases were discharged from the pediatric observation unit. 96 of all cases were transferred from the observation unit to the ward for continuation of medical treatment. Conclusion: 535 subjects were hospitalized in the Emergency Pediatric Observation Unit and 82% of these subjects were discharged from the Emergency Pediatric Observation Unit. This reality shows the benefits of this unit as prevention of unnecessary and over- hospitalizations, decreament in hospital stay intervals, early diagnosis of clinically suspicious subjects, prevention of delay in their treatment and increasing patient satisfaction by early discharge. Pediatric emergency observation units are a must for the pediatric emergency services for the better evaluation and treatment of children.

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