Résumé
La valoración pediátrica de urgencias tiene características especiales respecto al resto de la atención pediátrica. El diagnóstico final será una prioridad secundaria. Es una evaluación clínica, cuyo intento principal es la identificación de aspectos anatómicos y fisiológicos anormales, la estimación de la gravedad de la enfermedad o lesión y la determinación de la necesidad de tratamiento urgente. El objetivo de esta colaboración es brindar una sistemática clara, con una secuencia de valoraciones y acciones que sirvan de base para la toma de decisiones clínicas orientadas a la estabilización del paciente y a evitar situaciones que pueden amenazar la vida en poco tiempo. El triángulo de evaluación pediátrica, la secuencia ABCDE, una breve anamnesis y examen enfocado que identifique el motivo de consulta de mayor prioridad, signos de alarma que pueden cambiar la prioridad y las reevaluaciones frecuentes serán los pilares de la actuación médica. Con el propósito de respetar el derecho del niño al disfrute del más alto nivel posible de salud, de garantizar la calidad asistencial y la seguridad de los pacientes pediátricos con entidades agudas o traumatismos, el grupo nacional de pediatría desarrolló y aprobó la guía de valoración pediátrica de urgencias en Cuba. Mediante la aplicación de esta guía se puede optimizar el proceso de valoración pediátrica de urgencias de forma que los pacientes de este segmento de edad reciban el nivel de cuidados médicos más apropiado para su situación clínica(AU)
The pediatric emergency assessment has special characteristics with respect to the rest of pediatric care. The final diagnosis will be a secondary priority. It is a clinical evaluation, and the main purpose of it is the identification of abnormal anatomical and physiological aspects, the estimation of the severity of the disease or injury and the determination of the need for urgent treatment. The objective of this collaboration is to provide a clear system, with a sequence of assessments and actions that serve as a basis for clinical decision-making aimed at stabilizing the patient and avoiding life-threatening situations in a short time. The pediatric assessment triangle, the ABCDE sequence, a brief history and focused examination that identifies the highest priority reason for consultation, warning signs that may change priority and frequent re-evaluations will be the pillars of medical action. To respect the right of the child to have access to the highest possible level of health, to guarantee the quality of care and its safety in the face of acute conditions or trauma, the National Group of Pediatrics developed and approved the guide for pediatric emergency assessment in Cuba. Through its application, the pediatric emergency evaluation process can be optimized so that patients of this age segment receive the most appropriate level of medical care for their clinical situation(AU)
Sujets)
Humains , Nouveau-né , Nourrisson , Enfant d'âge préscolaire , Enfant , Directives , Respiration , Compétence clinique , Urgences , Prise en charge des voies aériennes , Soins aux patients/méthodes , Manifestations neurologiquesRésumé
The pediatric emergency assessment,recognition and stability (PEARS) courses were launched by American Heart Association in December 2007.The Shanghai Children's Medical Center (SCMC) affiliated to the Medicine School of Shanghai Jiao Tong University implemented the PEARS course training for all pediatric health care staff in batches in 2015 with the purpose of enhancing the capacity of initial judgment and stability and practicing the high-quality cardiopulmonary resuscitation,which achieved good results and better training satisfaction.The PEARS courses are helpful for paramedics to master the pediatric first-aid system evaluation method,and identification;assessment and processing of severe children properly,and meanwhile also emphasize the teamwork.The PEARS courses meet the requirements of the clinical practice of paramedics,and bear strong clinical practicability and maneuverability,furthermore,the training of them is effective in reducing medical errors.Consequently,it is recommended that the training is added into the continuing education and vocational education.
Résumé
Transient ischemic attack(TIA)is a common ischemic cerebrovascular disease,and the incidence of secondary ischemic stroke and cardiovascular events is very high.It needs to be assessed and managed urgently.The article presents the contents of emergency assessment of TIA,and emphasizes the importance of overall assessment.