Pediatrics is a science that studies the patterns of growth and development of healthy children, as well as the causes of diseases (etiology), the mechanisms of disease formation (pathogenesis), disease recognition (clinical diagnosis based on the basic symptoms and syndromes of the disease, laboratory (general clinical and specific) and additional instrumental research methods), i.e. diagnosis, treatment, prevention of the disease – prevention.
Medical care for children from 0 to 18 years of age is provided by inpatient and outpatient clinics.
The main types of children’s medical and preventive institutions of medical institutions:
– Children’s Hospital (hospital)
– Children’s polyclinic
– Children’s health resort
In addition, medical care can be provided to children in specialized departments of hospitals and polyclinics for adults, children’s departments of maternity hospitals, perinatal centers, consultative and diagnostic centers, centers and departments of rehabilitation treatment, etc.
To help children who are in an urgent situation, there is a service of round-the-clock medical care at home, ambulance stations and emergency medical services.
Medical and preventive care, mainly preventive, is also provided in educational institutions, such as a children’s home, a nursery-garden complex, a school, a health camp (including a sanatorium type), etc.
The children’s hospital plays a special role in the health care system. It is here that the seriously ill are hospitalized, where modern diagnostic equipment is concentrated, highly qualified doctors and nurses work, and professional training of medical personnel is conducted.
Children’s Hospital-a health care facility for children and adolescents under the age of 17 years, who need constant inpatient medical supervision, intensive care or specialized care.
There are different types of children’s hospitals.
By organization system:
– combined with a polyclinic
By volume of activity:
– Hospitals of a particular category, determined by the capacity (number of beds)
By administrative affiliation:
– District offices
– Clinical (if a department of a medical or research institute operates on the basis of a hospital)
– Republican children’s hospitals
The main goal of the modern children’s hospital is to restore the health of a sick child.
To achieve this goal, the staff of the medical institution must provide the patient with multi-stage care, namely::
– Carry out the diagnosis of the disease
– Perform emergency therapy
– Basic treatment and rehabilitation treatment, including rehabilitation (social assistance measures)
The employees of the children’s hospital are assigned certain duties, the main of which are the following:
– Providing children with highly qualified medical care
– Introduction of modern methods of diagnosis, treatment and prevention into practice
– Advisory and methodological work
In each children’s hospital there are:
– emergency department (emergency room),
– hospital (medical departments),
– medical and diagnostic department or corresponding offices and laboratories,
– pathology department (morgue),
– auxiliary units (pharmacy, food department, medical statistics office, medical archive, administrative and economic part, library, etc.).
The work of the reception department (rest). The first meeting of the sick child with the medical staff takes place in the emergency department. Its main task is to organize the reception and hospitalization of sick children. The success of subsequent treatment largely depends on the correct and prompt work of this department. When a patient is admitted, a preliminary diagnosis is made, the validity of hospitalization is assessed, and emergency medical care is provided if necessary.
The reception department consists of:
– lobby-waiting rooms,
– reception and inspection boxes,
– insulation boxes for 1-2 beds,
– sanitary security guard,
– doctor’s office,
– treatment and dressing,
– laboratories for urgent tests,
– rooms for medical staff,
– toilets and other rooms.
The number of reception and examination boxes should be 3% of the number of beds in the hospital.
Employees of the reception department conduct:
– registration of the movement of patients (registration of incoming, discharged, transferred to other hospitals, deceased),
– conduct a medical examination of the patient,
– provide emergency medical care,
– make a referral to the appropriate department,
– sanitary treatment,
– isolation of infectious patients.
In the same department there is a reference.
The presence of several reception and examination boxes allows you to separately receive therapeutic, surgical and infectious patients, infants and newborns.
The intensive care unit is usually located next to the emergency room, so when a patient is admitted in an extremely serious condition, he is immediately placed in the intensive care unit, essentially bypassing the emergency room. All necessary documentation is issued “in the course” of the necessary intensive care. Emergency care for the child, in addition, can be provided in the intensive care unit, which is located at the emergency department.
Children are taken to the hospital by ambulance or by their parents at the direction of the doctor of the children’s polyclinic and other children’s institutions or without direction (“gravity”). In addition to the ticket (referral) for hospitalization, other documents are also submitted: an extract from the child’s development history, data from laboratory and instrumental studies, information about contacts with infectious patients at home from the district pediatrician and, if the child is “organized”, from the doctor of the school-preschool department. Without documents, patients can be admitted to the hospital only in case of emergency conditions.
When a child is admitted to the hospital without the parents ‘ knowledge, the latter are immediately notified of this by the staff of the emergency department. If it is impossible to obtain information about the child and his parents, the patient’s admission is registered in a special journal and a statement is made to the police. In large children’s hospitals, the reception of patients is conducted by specially designated staff, in small hospitals-on-duty staff.
The reception of a sick child is conducted in a strict sequence:
– medical examination,
– necessary medical care,
– sanitary treatment,
– transfer (transportation) to the appropriate department.
The nurse registers the admission of the patient in the journal, fills in the passport part of the “Medical card of the inpatient patient”, f. 003/y (medical history), enters the number of the insurance policy, measures the body temperature, informs the doctor of the information received.
After examining the child, the nurse receives recommendations from the doctor regarding the nature of the sanitary treatment. Usually, sanitary treatment consists in carrying out a hygienic bath or shower; if pediculosis (lice) is detected or nits are detected, the appropriate treatment of the scalp, underwear is carried out. The exception is made by patients who are in an extremely serious condition. They are given first aid and only if there are no contraindications, they are sanitized.
After sanitary treatment, the child is transported to the medical department. So-called “planned” patients should not stay in the emergency room for more than 30 minutes.
With a mass admission of patients, a certain order of priority of hospitalization is observed: first, the seriously ill are treated, then the moderate-severe, and last of all, the “planned” patients who do not need urgent treatment.