关键词: 儿童危重症, 早期识别, 动态复评, 院前 - 院内衔接

Abstract: As the initial site of care for pediatric emergencies and critical illness，the outpatient and emergency department plays a decisive role in patient outcomes，with assessment performance directly influencing prognosis. In high-demand clinical settings，the combination of insidious disease onset and limited physiological reserve in children complicates early risk recognition. Emergency assessment should therefore be conceptualized as a continuous process spanning prehospital management，transport，and inhospital evaluation rather than an isolated in-hospital task. Despite substantial progress in pediatric emergency system development，further integration between prehospital and inhospital assessment—particularly in unified risk frameworks and continuity of dynamic monitoring—is warranted. This paper reviews current practices and emphasizes physiology-centered clinical reasoning and dynamic reassessment as key strategies for detecting occult critical illness，with the goal of strengthening anticipatory risk appraisal and enhancing the resilience of the pediatric emergency care continuum.

Key words: pediatric critical illness, early recognition, dynamic reassessment, pre-hospital and hospital linkage