Name: 你想成為一名兒科主治醫師嗎？ (So You Want to Be a PEDIATRIC INTENSIVIST [Ep. 37])
Uploaded: 2023-01-17T17:57:08.000Z
Duration: 11 min 8 s

So you want to be a pediatric intensivist.

所以你想成為一名兒科強化治療師。

You love children and want to help take care of some of the sickest patients in the hospital.

你熱愛兒童，並希望幫助照顧醫院裡一些病重的病人。

Let’s debunk the public perception myths and give it to you straight.

讓我們揭穿公眾認知的神話，直接給你看。

This is the reality of pediatric critical care.

Welcome to our next installment in So You Want to Be.

歡迎來到《你想成為什麼樣的人》的下一篇文章。

In this series, we highlight a specific specialty within medicine, such as pediatric critical

在這個系列中，我們強調醫學中的一個特定專業，如兒科危重病人。

care, and help you decide if it’s a good fit for you.

護理，並幫助你決定它是否適合你。

You can find the other specialties on our So You Want To Be playlist.

你可以在我們的So You Want To Be播放列表中找到其他專業。

If you want to vote in upcoming polls to decide what future specialties we cover, make sure

如果你想在即將舉行的投票中投票，以決定我們未來涵蓋的專業，請確保

If you’d like to see what being a pediatric intensivist looks like, check out my second

如果你想看看作為一名兒科強化治療師是什麼樣子的，請看我的第二篇文章。

channel, Kevin Jubbal, M.D., where we’ll be covering a day in the life of a pediatric

在這裡，我們將報道一位小兒科醫生的一天，他叫凱文-朱巴爾，醫學博士。

Pediatric critical care is the specialty of medicine focused on the treatment of seriously

兒科重症監護是專注於治療嚴重疾病的醫學專業。

ill children from birth to 18 years old and beyond.

從出生到18歲及以上的患病兒童。

Much like pediatricians, pediatric intensivists are the masters of physiology and pharmacology.

與兒科醫生一樣，兒科強化治療師是生理學和藥理學的大師。

They use the wide breadth of knowledge from medical school and residency and apply it

他們利用從醫學院和住院醫師那裡獲得的廣泛知識，並將其用於

On any given day, a pediatric intensivist could be called to take care of a burn patient,

在任何一天，一位兒科強化治療師都可能被叫去照顧一個燒傷病人。

a type I diabetic in diabetic crisis, or a patient with a respiratory infection on a

處於糖尿病危機中的I型糖尿病患者，或呼吸道感染的患者，正在接受治療。

ventilator, each with their own set of needs.

呼吸機，每個人都有自己的一套需求。

As such, they need to have a working knowledge of every body system and the various ways

是以，他們需要對每個身體系統和各種方式有一個工作上的瞭解。

Furthermore, pediatric intensivists see patients across the entire developmental spectrum.

此外，兒科強化治療師看到的病人跨越了整個發展光譜。

Patients that are up to 1 month old have different needs than patients who are 1 month to 1 year

1個月以內的病人與1個月至1年的病人有不同的需求。

Each developmental range has different normal values for vital signs, lab results, drug

每個發育範圍都有不同的生命體徵、實驗室結果、藥物的正常值。

Pediatric intensivists have to always consider the patient’s specific disease or condition

兒科強化治療師必須始終考慮病人的具體疾病或狀況

Unlike many other specialties within pediatrics, pediatric intensivists perform a variety of

與兒科內的許多其他專業不同，兒科強化治療師進行各種

They perform intubations for children needing ventilatory support.

他們為需要呼吸機支持的兒童進行插管。

They place arterial catheters for children needing blood pressure monitoring and venous

他們為需要監測血壓的兒童放置動脈導管，為需要監測血壓的兒童放置靜脈導管。

catheters for the safe delivery of some medications.

用於安全輸送某些藥物的導管。

They place chest tubes for children with pneumothoraces or pleural fluid collections.

他們為患有氣胸或胸腔積液的兒童放置胸管。

And they perform a number of procedures for children needing artificial organ support

而且他們為需要人工器官支持的兒童進行了一系列的手術

— whether that be the heart, lungs, kidneys, or another organ.

- 無論是心臟、肺部、腎臟，還是其他器官。

There are a few ways to categorize a pediatric intensivist’s work.

有幾種方法可以將兒科強化治療師的工作進行分類。

First, there’s academic vs community and private practice.

首先，是學術界與社區和私人診所。

Academic pediatric intensivists are typically employed by a hospital or university affiliated

學術性的兒科強化治療師通常受僱於一家醫院或大學的附屬機構。

They will split their time between treating patients in the hospital and teaching.

他們將在醫院裡治療病人和教學之間分配時間。

Many academic positions also require administrative involvement or committee work within the hospital.

許多學術職位還需要參與醫院內的行政管理或委員會工作。

In contrast, community pediatric intensivists are employed by a community children’s hospital

相比之下，社區兒科強化治療師是由社區兒童醫院僱傭的。

and private practice pediatric intensivists are employed by a private group that provides

和私人診所的兒科強化治療師受僱於一個私人集團，提供

They will generally have less academic involvement; however, hybrid positions do exist.

他們一般會有較少的學術參與；然而，確實存在混合職位。

Relative to other specialties, the day to day life of a pediatric intensivist in the

相對於其他專業而言，小兒科強化治療師的日常工作是非常重要的。

academic vs private practice vs community setting does not differ much.

學術界與私人診所與社區環境沒有太大區別。

Given the nature of pediatric critical care, physicians working in this specialty will

鑑於兒科重症監護的性質，在這個專業工作的醫生將

almost always work in the hospital setting and take care of a wide variety of critically

幾乎總是在醫院環境中工作，照顧各種各樣的危重病人。

In terms of lifestyle, there is also little difference between academic, private practice,

就生活方式而言，學術界、私人診所之間也沒有什麼區別。

On-call responsibilities are more dependent on the specific hospital or group that you

隨叫隨到的責任更多的是取決於你所在的具體醫院或集團。

work for than they are on the type of practice.

他們的工作比他們的實踐類型更重要。

In some hospitals, you may be required to be on call several nights a week.

在一些醫院，你可能被要求每週有幾個晚上待命。

In others, you may have a more typical 8-5 schedule with on-call responsibilities occurring

在其他情況下，你可能有一個更典型的8-5的時間表，並有隨叫隨到的責任發生。

In terms of compensation, pediatric intensivists working in the private practice or community

在報酬方面，在私人診所或社區工作的兒科強化治療師

settings will typically earn more than their academic colleagues.

設置通常會比他們的學術同事賺得更多。

According to the 2020 MGMA Physician Compensation Report, the average salary is between $290,000

根據2020年MGMA醫生薪酬報告，平均工資在29萬美元之間。

This brings me to the next way of differentiating a pediatric critical care doctor's practice

這讓我想到下一個區分兒科重症監護醫生業務的方法

which is critical care vs pediatric sedation.

Whereas most pediatric intensivists will work in a hospital’s pediatric intensive care

而大多數兒科強化治療師會在醫院的兒科重症監護室工作。

unit and take care of critically ill children, there are some who perform primarily pediatric

照顧危重病人，也有一些人主要從事小兒科工作。

Pediatric sedation is typically offered within a children’s hospital or radiology center

小兒鎮靜通常在兒童醫院或放射科中心內提供。

where you have children who are too young developmentally to know to stay still.

如果你有孩子，他們在發育上太年輕，不知道要保持靜止。

In order to perform the required study or procedure, these children are given sedatives

為了進行所需的研究或程序，這些兒童被給予鎮靜劑。

and monitored by a pediatric critical care physician to ensure there are no unforeseen

並由兒科重症監護醫生進行監測，以確保沒有不可預見的風險。

Some pediatric intensivists will do pediatric sedation in addition to their pediatric ICU

一些兒科強化治療師除了做兒科ICU外，還會做兒科鎮靜治療。

responsibilities whereas others will do it full-time.

In terms of compensation, pediatric intensivists working predominantly in sedation will generally

在報酬方面，主要從事鎮靜工作的兒科強化治療師通常會

earn less than their pediatric ICU colleagues.

他們的收入比兒科ICU的同事少。

Let’s clear up some of the misconceptions about pediatric critical care.

讓我們澄清一些關於兒科重症監護的誤解。

The biggest misconception is that it’s a sad job.

最大的誤解是認為這是一份悲哀的工作。

Unlike adult critical care, the majority of children admitted to the pediatric ICU improve

與成人重症監護不同的是，進入兒科重症監護室的大多數兒童都能得到改善。

Multiple studies estimate that the mortality rate for children admitted to the pediatric

多項研究估計，小兒科收治的兒童的死亡率為0.5%。

ICU is only around 3%, meaning that approximately 97% of children recover.

ICU的比例只有3%左右，這意味著大約97%的兒童可以康復。

This isn’t to say that you won’t experience death or sad outcomes; however, it is less

這並不是說你不會經歷死亡或悲傷的結果；然而，它是較少的。

Many people also believe that respiratory infections make up the bulk of a pediatric

許多人還認為，呼吸道感染構成了小兒疾病的大部分。

In reality, pediatric intensivists see a broad spectrum of patients with a variety of issues.

在現實中，兒科強化治療師看到的病人範圍很廣，有各種各樣的問題。

To become a pediatric intensivist, you must complete 4 years of medical school, followed

要成為一名兒科強化治療師，你必須完成4年的醫學院學習，然後是

by 3 years of pediatric residency, and 3 years of pediatric critical care fellowship.

通過3年的兒科住院醫師培訓，以及3年的兒科重症監護研究。

Some will opt for an additional chief year during residency to increase their competitiveness

有些人會選擇在住院期間增加一個首席年，以增加他們的競爭力。

There are also dual pediatric critical care and anesthesiology fellowship programs that

也有小兒重症監護和麻醉學的雙重研究計劃。

are 5 years in duration and allow pediatricians to become dual-board certified in pediatric

為期5年，允許兒科醫生成為兒科的雙板認證。

critical care and anesthesiology upon completion.

完成後，將成為重症監護和麻醉學專家。

In terms of competitiveness, pediatric critical care is one of the more competitive pediatric

就競爭力而言，兒科重症監護是競爭力較強的兒科之一。

subspecialties along with pediatric emergency medicine, pediatric cardiology, and pediatric

與小兒急診醫學、小兒心臟病學和小兒護理學一起，成為小兒科的亞專科。

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你想成為一名兒科主治醫師嗎？ (So You Want to Be a PEDIATRIC INTENSIVIST [Ep. 37])

specific

incredibly

opportunity

critical