兒童事故傷害嚴重性與嚴重度之評估工具

事故傷害一直是危害國內兒童健康的嚴重問題，即使是官方公佈的死亡資料，仍無法真正了解兒童事故傷害問題的嚴重程度與影響層面。過去對於兒童事故傷害測量指標是否能適當反應出受傷嚴重度的真實性，一直值得討論。本文將過去衛生單位之統計或評估時常用的兒童事故傷害測量方法分為－發生的嚴重性及傷害的程度兩部分加以評估。過去對於兒童事故傷害測量的受傷程度評估，除了兒童外傷指數(Pediatric Trauma Score-PTS)與兒童昏迷指數(Pediatric Glasgow Coma Score-PGCS)是以兒童為評量對象發展出的評估工具，所評量出的結果之正確性比較高之外，其他的測量方法都是以成人的標準來評量兒童的受傷程度；儘管PTS及PGCS兩個指數是針對兒童所發展出的評量工具，但是這兩個指數並無法正確評估中毒、窒息與溺水等事故傷害之受傷的嚴重性。未來期待能藉由建立完整的「事故傷害監測系統」，收集到最完整、詳盡的資料，經由這些資料的分析過程中，發展出適用於國人兒童以及各種事故傷害的評量工具，明確且完整的表達出事故傷害之嚴重度，喚起國人的重視及瞭解事故傷害對兒童所造成的不良影響。

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並列摘要

Accidental injuries have always been a serious children's health issue. The real impact caused by accidental injuries is not fully represented in the death rates reported by governmental agencies. The suitability of childhood accidental injury assessment indices used in the past, and their dissimilation ability to reflect the severity of injury and accuracy of data warrant further discussion. This article evaluates frequently used childhood injury assessment methods that employ two dimensions-severity and extent of injury. The accuracy of these assessment methods is controversial, especially regarding the extent of injury at the time of the accident. Except for the Pediatric Trauma Score (PTS) and the Pediatric Glasgow Coma Score (PCGS), instruments designed specifically for children, all other assessment methods evaluate the extent of injury using standards and norms based upon adults. However, even though PTS and PGCS are children-specific, they do not accurately evaluate the severity of injury in certain types of accidents such as intoxication, asphyxia and drowning. It is hoped that by developing a comprehensive ”accidental injury monitoring system,” new tools will be developed to collect more complete and accurate childhood injury severity data. In addition, this extensive data may raise public awareness about the negative impact of accidental injuries in childhood.