Madan A K, Rentz D E, Wahle M J, Flint L M
Department of Surgery, Tulane University School of Medicine, Louisiana State University, New Orleans, USA.
South Med J. 2001 Mar;94(3):277-80.
Universal precautions during resuscitations are mandated by hospital regulations. We documented adherence to universal precautions during trauma resuscitations at our level I trauma center.
During trauma resuscitations, a medical student using an elevated viewing platform observed health care workers (HCWs) for the use of barrier precautions (BPs): gloves, masks, gowns, and eyewear. Only HCWs having direct patient contact were included. The purpose of the observation was not disclosed to those being observed.
In 12 resuscitations involving 104 HCWs, none had 100% compliance with BPs. Compliance rates for individual BPs were gloves, 98%; eyewear (any type), 52%; gowns, 38%; masks, 10%; and eyewear (with side protectors), 9%. Resuscitations in which bleeding was observed involved 59 HCWs with 38% compliance; only 2 used full BPs. No difference in compliance rates occurred during the study period.
Experienced trauma care HCWs are cavalier regarding blood-borne disease exposure risks. Measures to encourage (or force) compliance are needed.
医院规定在复苏过程中必须采取通用防护措施。我们记录了在我们的一级创伤中心进行创伤复苏时通用防护措施的遵守情况。
在创伤复苏期间，一名医学生使用高架观察平台观察医护人员（HCW）使用屏障防护措施（BP）的情况：手套、口罩、防护服和护目镜。仅纳入直接接触患者的医护人员。观察目的未向被观察者透露。
在涉及104名医护人员的12次复苏中，无人能100%遵守屏障防护措施。各项屏障防护措施的遵守率分别为：手套98%；护目镜（任何类型）52%；防护服38%；口罩10%；带侧护板的护目镜9%。观察到有出血情况的复苏涉及59名医护人员，遵守率为38%；只有2人使用了全套屏障防护措施。在研究期间，遵守率没有差异。
经验丰富的创伤护理医护人员对血源性疾病暴露风险满不在乎。需要采取措施鼓励（或强制）遵守。
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