Children are not just small adults. Obvious, right? But, if you were to ask those in pediatrics, they might say that a lot can get missed in the obvious.
在过去的二十年中，全国急诊科（EDS）的患者增加了，其中近25％是儿童。1Experts worry that, because children are being brought primarily to facilities that do not specialize in pediatric care, children may not be receiving the specialized treatment they deserve.2儿童，尤其是不到一岁的婴儿，与成年人有明显的解剖学和生理差异，诊断和治疗所需的护理是独一无二的，而且经常错过。
在紧急情况下，孩子的病情可能会迅速恶化，现场的父母会感到恐慌，床边的护理团队可能会承受压力程度。因为这，迫切需要改善小儿训练 - 以确保我们说“孩子不仅是小成年人”时，我们不会错过任何东西。
Experts have put a training emphasis on determining the appropriate clinical pathway, administering medications, and working within an interdisciplinary team. Research suggests that training in these three areas can make a positive impact on pediatric patient outcomes.
- 路易丝·惠特尔（Louise Whittle），父母的重病孩子协会6
根据美国儿科学会（AAP）的数据，许多组织已经开始实施全尺寸的小儿模拟工作。一个例子是小儿大本营，这是由Laerdal支持并由Weill Cornell医学院主持的沉浸式模拟活动，重点是进行微调和增强临床通道技能，而在面对儿科紧急情况时，提供者使用的是该技能。4
其他组织正在使用顺序模拟（SQS）来准备前线人员，以在患者旅程的各个方面参与集成或以人为本的护理。5这种模拟形式着重于重要时刻，例如交接（即从父母到医师，从救护车到ED等），信息共享，角色分配和个人任务。
Being able to assess symptoms, measure physiological differences and improvements, and perform interventions will allow learners to suspend disbelief and move through the simulation without roadblocks.
In pediatrics, the incidence of errors with medication can be as high as 1 in every 6 orders.7This may be caused, in part, by the fact that children vary greatly in weight, body surface area, and organ system maturity, which affects their ability to metabolize and excrete medications.8
In a study observing nursing students using simulation to address a complex pediatric patient case, only 22% of students provided correct medication administration before the training. After the training, 96% were successful in dilution techniques and eighty-eight percent were able to provide accurate IV pump rates.10
Simulation training prepares nurses and physicians for the inevitable stress, noise, and chaos that will come with an infant in critical condition.
When an infant is brought to the ED, it's quite possible that a team can form that has little familiarity with each other and yet must perform like a well oiled machine. So, why not give them that training opportunity?
Research by the Cincinnati Children's Hospital Medical Center asserts high-fidelity simulation as an effective method of enhancing and evaluating interdisciplinary team training in the context of pediatric trauma patients.11This same study concluded that improved team performance directly correlated with more efficient care and fewer errors.
Emergency Medical Services (EMS) are an added dynamic, as approximately 7%-13% of all EMS calls involve pediatric patients.12培训以融入所有可能的护理人员可以导致更有效的团队动态，当然可以是更准确的临床途径。
Additionally, emphasizing closed-loop communication techniques in simulations can not only help to reduce the risk of error, but also increase the speed and efficiency when treating a pediatric patient in crisis.
在儿科重症监护环境中，婴儿的生命可能会受到威胁，单个错误可能会导致影响。为医疗保健提供者提供模拟练习的机会，使他们能够在遇到真正的患者之前设定期望并行使有效的团队沟通技巧。
Of the nine million children under the age of five that die each year, it is estimated that seventy percent of these are due to conditions that can be prevented or treated if diagnosed correctly.14专家建议在临床途径的决策过程中集中小儿培训工作，以小剂量为儿童进行药物治疗，并与跨学科团队进行培训以改善整体沟通。
仿真是一种有效的培训方法，可以纳入这些技能中的每一种。从头到尾进行患者病例之后，真正患者会经历的许多跌宕起伏，可以通过提高技能和临床专业知识来增强现有的儿科培训课程。15
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