Paediatric Nursing Department, Faculty of Nursing

Universitas Indonesia
August 2019
§ Understand Acute Definition
§ Understand the Domain of Acute Care
§ Able to Give an Example of Acute Illnesses in
Children
§ Understand the Impact of Acute Illnesses on
Children and Their Family
§ Understand the Roles of Paediatric Nurses in
Managing Acute Illnesses
§ A disease characterized by a relatively sudden onset of symptoms
that are usually severe. An episode of acute disease results in
recovery to a state comparable to the patient's condition of health
and activity before the disease, in passage into a chronic phase, or
in death. Examples are pneumonia and appendicitis (Mosby's
Medical Dictionary, 2009).

§ Epidemiology Any condition—eg infection, trauma, pregnancy,

fracture, with a short, often < 1 month clinical course; ADs usually
respond to therapy; a return to a state of complete–pre-morbid
health is the rule (McGraw-Hill Concise Dictionary of Modern
Medicine, 2002).
§ An illness with symptoms severe enough to limit activity or
require medical attention. Respiratory illness accounts for
approximately 50% of all acute conditions, 11% are caused by
infections and parasitic disease, and 15% are caused by injuries
§ Acute illnesses are usually isolated to one bodily area and
respond to treatment. In contrast, long-term conditions
frequently involve multiple systems and have an uncertain
future.
§ An acute disease can be mild, severe or even fatal. The term
"acute" does not indicate the severity of the disease. Instead, it
indicates how long the disease lasts and how quickly it
develops.
§ Disorder with sudden onset and short duration of
symptoms (Medical Dictionary for the Health
Professions and Nursing, 2012).
§ Acute often also connotes an illness that is of short
duration, rapidly progressive, and in need of urgent
care.
§ Acute Illness: (1) Any illness that develops quickly, is
intense or severe and lasts a relatively short period of
time.(2) Any condition—e.g., infection, trauma,
fracture—with a short (often less than 1 month) clinical
course. Acute illnesses usually respond to therapy; a
return to a state of complete—pre-morbid—health is
the norm (Segen's Medical Dictionary, 2012).
§ An acute disease is a disease, a short course, or
both. Acute may be used to distinguish
a disease from a chronic form, such
as acute leukaemia and chronic leukaemia, or to
highlight the sudden onset of a disease, such
as acute myocardial infarction.
§ A disease or disorder that lasts a short time, comes
on rapidly, and is accompanied by
distinct symptoms (Compare to chronic disease)
§Acute services therefore include all
promotive, preventive, curative, rehabilitative
or palliative actions, whether oriented
towards individuals or populations, whose
primary purpose is to improve health and
whose effectiveness largely depends on time-
sensitive and, frequently, rapid intervention.
 sudden
disruption

uncertain

Challenge the child’s emotional well-being

and the integrity of the family system
§ A proposed definition of acute care includes the health
system components, or care delivery platforms, used to
treat sudden, often unexpected, urgent or emergent
episodes of injury and illness that can lead to death or
disability without rapid intervention. The term acute care
encompasses a range of clinical health-care functions,
including emergency medicine, trauma care, pre-hospital
emergency care, acute care surgery, critical care, urgent
care and short-term inpatient stabilization (Fig. 1).
a. Treatment of individuals with acute surgical needs, such as life-threatening
injuries, acute appendicitis or strangulated hernias.
b. Treatment of individuals with acute life- or limb-threatening medical and
potentially surgical needs, such as acute myocardial infarctions or acute
cerebrovascular accidents, or evaluation of patients with abdominal pain.
c. Ambulatory care in a facility delivering medical care outside a hospital
emergency department, usually on an unscheduled, walk-in basis. Examples
include evaluation of an injured ankle or fever in a child.
d. Treatment of individuals with acute needs before delivery of definitive treatment.
Examples include administering intravenous fluids to a critically injured patient
before transfer to an operating room.
e. Care provided in the community until the patient arrives at a formal health-care
facility capable of giving definitive care. Examples include delivery of care by
ambulance personnel or evaluation of acute health problems by local health-
care providers.
f. The specialized care of patients whose conditions are life-threatening and who
require comprehensive care and constant monitoring, usually in intensive care
units. Examples are patients with severe respiratory problems requiring
endotracheal intubation and patients with seizures caused by cerebral malaria.
§ Anxiety
§ Fear
§ Pain
§ Discomfort Nurses must be SENSITIVE to these experiences and
§ Surprise develop A PLAN OF CARE that ENHANCES family
function and REDUCES the stressors associated with
§ Fatigue interaction in the acute care setting
§ Frustration
§ Mistrust
§ Anger
§ Facilitating entry into the acute care setting
§ Integrating age-appropriate principles of growth and development in
all care
§ Supervising or implementing routine care and procedures in a
nonthreatening way
§ Maintaining, to the extent possible, the child’s daily routines
§ Maintaining safety
§ Responding to the unique psychosocial needs of the child and family
§ Addressing the needs of the child undergoing surgery
§ Implementing effective discharge
§ Bowden, V.R., Greenberg, C.S. (2010). Children and their families: the continuum of
care. 2nd ed. Philadelphia: Lippincott Wiliams & Wilkins.
§ Hirshon, J.M., et all. (2013). Health systems and services: the role of acute care.
Bulletin of the World Health Organization. 91: 386-388. DOI:
http://dx.doi.org/10.2471/BLT.12.112664
§ Mosby's Medical Dictionary, 2009
§ McGraw-Hill Concise Dictionary of Modern Medicine, 2002
§ Medical Dictionary for the Health Professions and Nursing, 2012
§ Segen's Medical Dictionary, 2012