兒童重症院際轉運的現況與展望

The Current Status and Prospects of Inter Hospital Transport for Critical Children

儘管台灣的醫療專業人士在早產嬰兒的轉運方面經驗豐富，但鮮有團隊投入資源和努力來研究兒童和青少年在多樣化體型、生理特點和疾病樣貌下的轉運效益。國立台灣大學兒童醫院是台灣兒童健康的領導者和推動者，因此有責任倡導兒童健康並改進兒童護理。本團隊一直接收來自各地轉運的兒童；然而，本團隊也注意到對於危重病童來說，缺乏能量的轉運系統會對他們構成巨大的風險。過去，危重病童常常是由普通救護車轉運，沒有專業的兒科專業人員或兒童專用設備，甚至有些兒童由其父母使用高鐵或公共交通工具如巴士送往醫院。這些非專業的轉運有時需要在到達醫院後進行緊急復甦以拯救患者的生命。因此，在生育率下降的時代，建立專業的兒科轉運團隊至關重要。本文討論了本團隊協助衛生福利部制定台灣《兒科危重病轉運團隊建立指南》的角色。為有效改善臨床結果，需要採取多方面的措施，包括員工教育培訓和設備政策的優化，以應對多種兒科危重病轉運的情況。

Although Taiwan medical professionals are experienced in transfer of premature newborns, few team has devoted resources and efforts to transfer effectiveness of children and adolescents with changing physical size, physiology, and disease patterns. National Taiwan University Children’s Hospital is a leader and promoter of children’s health in Taiwan, so it is our responsibility to advocate children’s health and improve children care. We have been receiving children from all over the world; however, we also noticed that a lack of capable transfer system for critically ill children would pose a great risk to them. In the past, critically ill children were transferred by conventional ambulance without pediatric professionals or equipment specific for children, and some children were even taken to hospitals by their parents using public transport like high-speed rail or buses. These unprofessional transfers sometimes made emergent resuscitation necessary to save the patients upon arrival. Therefore, the establishment of professional pediatric transfer team is crucial, especially in the era of sub-replacement fertility. This article discusses our role in assisting the Ministry of Health and Welfare to establish the“Guidelines for the Establishment of Pediatric Critical Care Transfer Teams􀞵in Taiwan. To effectively improve clinical outcomes, a multifaceted approach including staff education and training and optimization of equipment and policy is needed to manage the diverse situation of pediatric critical care transfer.