兒科急診十誡

The Ten Commandments Of Pediatric Emergency Medicine

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兒科急診十誡

The Ten Commandments Of Pediatric Emergency Medicine

The Journal of Emergency Medicine,
Vol. 27, No. 2, pp. 193–194, 2004

1.   小孩不是大人的縮小版

Children are not small adults

2.   生病和受傷的小孩會行為退化

Ill and injured children regress

要多花些時間，不要有太高的期待

 
3.   兒科必須同時治療兩位「病人」 （家屬和小孩）

The “patient” might be the one holding the child

4.   把小朋友當一回事

Kids are the real deal

小孩不喜歡來醫院

一般情況下，小朋友不會裝病

5.   實驗檢查和x-ray不能取代完整的病史和理學檢查

Laboratory tests and x-rays seldom beat a good history and physical examination

6.   人多好辦事

Many hands make light work

procedure 前做充分的準備，把事做對，一次做好

7.   確認、確認、再確認

Check and double-check. Then, check again

過敏史、藥物、劑量、左右

8.   小孩也會覺得痛，給予止痛劑

Children feel pain just like you do—treat it

9.   安排回診

Close the loop

10.  你是小孩的代言人

Above all, you are the child’s advocate

兒科急診十誡是急診十誡的補充加強版

急診十誡裡的原則依然適用

The Ten Commandments of Pediatric Emergency Medicine are designed to supplement and augment the Ten Commandments of Emergency Medicine, not to replace them.

The original commandments still hold.

急診十誡

The Ten Commandments of Emergency Medicine

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The 10 Commandments of Emergency Medicine

急診十誡


1.    Secure the ABCs.
       穩定 ABC (呼吸道、呼吸、循環)

2.    Consider or give naloxone, glucose and thiamine.
       (意識不清病患) 考慮給予 naloxone , glucose 及 thiamine

3.    Get a pregnancy test.
       (年輕女性腹痛) 做懷孕試驗

4.    Assume the worst-rule out serious disease.
       假定最糟的狀況，排除致命的診斷

5.    Do not send unstable patients to radiology.
       勿送不穩定病患到放射檢查室

6.    Look for the common red flags.
       尋找常見的警示

7.    Trust no one, believe nothing (not even yourself)
       check lab results and rethink clinical decisions.
       勿輕信任何人、任何事 (包括你自己)
       確認檢驗報告，重新做臨床診斷

8.    Learn from your mistakes.
       從錯誤中學習

9.    Do unto others as you would your family (and that includes coworkers).
       視病猶親

10.  When in doubt, err on the side of the patient.
       當猶豫不決時，以病患的利益為優先考量

Remember, malpractice is usually a result of violating one of the ten commandments!
切記！醫療過失常始因於違反急診十誡！

summarized from Dr. Slovis's article in Annals of Emergency Medicine 10 Oct. 1991.


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