急症儿童院前–康复闭环救助服务体系方案设计

Design of a Prehospital-to-Rehabilitation Closed-Loop Rescue Service System for Children with Acute Diseases

摘要: 目的：针对我国儿童急症救助服务链条呈阶段性、碎片化、重急救轻康复、家庭支持薄弱等问题，设计覆盖院前–康复全周期的闭环救助服务体系，并通过试点探索优化方案。方法：采用文献研究法、半结构化访谈法与试点模拟推演法，从紧急转运标准化、全周期病情跟踪、家长综合支持三个维度构建服务体系，制定各模块人员配置、工作表单、信息系统功能需求与关键节点质量控制等标准操作程序(SOP)，并以高热惊厥与重症肺炎为典型病种开展试点设计与推演。结果：形成由紧急转运服务、病情跟踪服务、家长综合支持服务三大模块及完整SOP构成的闭环救助服务体系，明确了各模块功能定位、运行流程、风险防控与质量控制机制，并提出试点数据收集与分析框架。结论：该体系可整合多环节资源，弥补传统急救重急性期、轻康复期与家庭支持的短板，提升儿童急症救助全过程的连续性与有效性，可为儿童全周期健康管理提供参考。

Abstract: Objective: To design a closed‑loop rescue service system covering the whole prehospital‑to‑rehabilitation continuum for children with acute diseases and optimize the scheme through pilot exploration, in view of the phased and fragmented pediatric emergency care service chain in China, the tendency to prioritize emergency treatment over rehabilitation, and weak family support. Methods: Literature review, semi-structured interviews and pilot simulation were adopted to construct the service system from three dimensions of standardized emergency transport, whole-course condition tracking and comprehensive parental support, and to develop standard operating procedures (SOPs) covering staffing, work forms, information system requirements and quality control at key nodes; febrile convulsion and severe pneumonia were selected as typical conditions for pilot design and simulation. Results: A closed-loop rescue service system composed of three modules, namely emergency transport, condition tracking and comprehensive parental support, together with complete SOPs, was formed, with functional positioning, operation process, risk prevention and quality control mechanisms defined, and a framework for pilot data collection and analysis proposed. Conclusion: The system can integrate resources of multiple links, make up for the shortcomings of traditional rescue that emphasizes acute-phase treatment while neglecting rehabilitation and family support, improve the continuity and effectiveness of the whole rescue process for children with acute diseases, and provide a reference for the whole-course health management of children.