국내 응급실의 소아 진료 양상과 준비 수준; 전국 응급의료센터 설문 조사

Abstract

Purpose: The goals of this study were to examine the preparedness of Korean emergency department’s (ED) in serving pediatric patients and to evaluate the current status of pediatric emergency care in Korea. Methods: We conducted a cross-sectional, web-based survey. The questionnaire was sent to the directors of 134Korean emergency medical centers. All correspondence was conducted by e-mail. The questionnaire topics included facility,personnel and equipment for pediatric patients, the pediatric patient consultation system, and policies related to pediatric patient sedation, management of suspicious child abuse cases, and discharge instructions for pediatric patients. Results: A total of 81 medical center directors (60.4%)responded to the survey. In only 3(3.7%) medical centers was there a separate pediatric ED, and 27 of the medical center EDs (33.3%) had no designated pediatric area. Twenty three EDs (28.4%) were equipped with pediatric emergency carts and 48 EDs (59.3%) had pediatric endotracheal tubes suitable for all ages of children. Pediatric department consultations performed at night or on weekends were mainly administered by low-grade (first and second year) residents, and in 13 EDs, emergency physicians had no way to consult the pediatric department during nights or weekends. Seventy EDs (86.4%) provided no discharge instruction for caregivers. Monitoring for sedated children undergoing radiologic study was unavailable in 53.1% of EDs. Conclusion: Significant under-preparedness exists in the current pediatric emergency services that were evaluated in this study. Further research and effort for the establishment of appropriate standards for facility, equipment, personnel and policies supporting pediatric emergency service are strongly needed.