Bir Çocuk Acil Servis Deneyimi: Ambulans Kullanım Nedenleri

Abstract

Amaç: Hastaneler arası hasta sevkleri, hastaların ileri tıbbi bakım ve tedaviye ihtiyaç duydukları ve sevk eden hastanedeki personel, ekipman ve tıbbi-teknik imkânların ihtiyaçları karşılamakta yetersiz kaldığı durumlarda yapılmaktadır. Bu çalışmanın amacı, çocuk acil servisine 112 acil sağlık hizmetleri aracılığıyla sevk edilen ve yine bu birimden başka sağlık kuruluşlarına sevki gerçekleştirilen hastaların demografik, klinik ve sevk sürecine ilişkin özelliklerini kapsamlı şekilde değerlendirmektir. Yöntem: Bu çalışmada, Ocak 2023 ile Aralık 2023 tarihleri arasında Samsun Eğitim ve Araştırma Hastanesi Çocuk Acil Servisine başvuran ve farklı merkezlere sevk edilen hastaların demografik özellikleri, başvuru zamanı, klinik şikayetleri, yatış yapılan servisler, sevk edildikleri sağlık kurumları ve sevk nedenleri retrospektif olarak incelendi. Bulgular: Toplam 873 hasta (626 gelen, 247 giden) çalışmaya dahil edildi. Hastaların yaş ortalaması 86,93±63,31 aydı. Gelen hastaların %79,7’si (n=499) önceden bildirim yapılmadan gönderilmişti. En sık sevklerin cuma günü, ilkbahar mevsiminde ve 16.00–24.00 saatleri arasındaki vardiyada gerçekleştiği saptandı. En yaygın başvuru nedenleri karın ağrısı (%26,7; n=167), nöbet (%11,9; n=75) ve solunum sıkıntısı (%8,9; n=56) idi. Gelen hastaların %56,7’si (n=355) hastaneye yatırıldı. Sevk edilen hastalarda en sık görülen tanılar nöbet bozuklukları (%23,8; n=59), travmatik yaralanmalar (%8,9; n=22) ve onkolojik hastalıklar oldu. Sonuç: Sevk zinciri, acil pediatrik hasta yönetiminin önemli bir bileşenidir. Sevk süreçlerinde yaşanan iletişim eksiklikleri ve kaynak yetersizlikleri, hasta bakım kalitesini doğrudan etkileyebilmektedir. Bu nedenle, sevk kriterlerinin standardize edilmesi, sağlık personeline yönelik hizmet içi eğitimlerin artırılması ve sistematik sağlık politikalarının geliştirilmesi gerekmektedir.

Keywords

• ambulans
• Çocuk Acil
• ön bildirim
• sevk

A Pediatric Emergency Department Experience: Causes of Ambulance Use

Abstract

Objective: Interhospital patient referrals occur when patients require advanced medical care and treatment and the staff, equipment, and medico-technical facilities at the referring hospital are insufficient to meet these needs. The aim of this study is to comprehensively evaluate the demographic, clinical and referral process characteristics of patients referred to the pediatric emergency department via 112 emergency health services and referred to other health institutions from this unit. Method: The demographic characteristics, time of admission, clinical complaints, inpatient services, referral centers, and reasons for referral were retrospectively analyzed in patients admitted to and referred from the pediatric emergency department of Samsun Training and Research Hospital between January 2023 and December 2023. Results: A total of 873 patients (626 incoming and 247 outgoing) were included in the study. The mean age of the patients was 86.93±63.31 months. Most of the incoming patients (79.7%, n=499) were transferred without prior notification. The most common day of admission was Friday, the most common season was spring, and the most common shift was 16-24 hours. The majority of patients were referred for abdominal pain (26.7%, n=167), seizures (11.9%, n=75), and respiratory distress (8.9%, n=56). Of the presenting patients, 56.7% (355/626) were admitted to the hospital. The most common diagnoses among the transferred patients were seizure disorders (23.8%, n=59), traumatic injuries (8.9%, n=22), and oncologic conditions. Conclusion: The referral chain plays a pivotal critical role in the management of pediatric emergencies. Deficiencies in communication and resources availability during the referral process may adversely affect impact the quality of patient care. Therefore, it is essential to standardize referral criteria, enhance in-service training for healthcare professionals, and implement structured health policies to ensure effective patient transfer and continuity of care.

Keywords

• ambulance
• Child Emergency
• prior notification
• referral

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