Sundaram R O, Parkinson R W
Department of Orthopaedics, Arrowe Park Hospital, Upton, Wirral, UK.
Ann R Coll Surg Engl. 2007 Apr;89(3):262-7. doi: 10.1308/003588407X168370.
We determined the compliance rates of orthopaedic trauma team members in applying universal precautions in major trauma resuscitation scenarios and the availability of universal precautions in accident and emergency (A&E) departments throughout England.
A national telephone survey was implemented contacting the first on-call orthopaedic surgeon and A&E departments in hospital trusts accepting major trauma throughout England. A questionnaire was employed to ascertain current practice, experience and availability of universal precautions when managing a major trauma patient.
Overall, 112 first on-call orthopaedic surgeons and 99 A&E departments responded. There was good compliance for using gloves (99%) and aprons (86%). There was poor compliance in using eye protectors (21%), face masks (18%), shoe covers (4%) and head caps (4%). Trainees applied universal precautions according to the level of risk they subjectively perceived. All A&E departments had gloves and aprons but the availability of the other universal precautions was less. Of trainees, 76 reported that all universal precautions were not readily available in the A&E department.
Orthopaedic trauma team members are very compliant in using gloves and aprons, but should be more compliant in using eye protectors. It is questionable whether face masks, head caps and shoe covers need to be used in all trauma scenarios. In general, universal precautions should be more available in the A&E departments. There should be better communication between A&E departments and the trauma team regarding the availability of universal precautions.
我们确定了骨科创伤团队成员在重大创伤复苏场景中应用通用防护措施的依从率,以及全英格兰事故与急救(A&E)部门通用防护措施的可用性。
开展了一项全国性电话调查,联系了全英格兰接收重大创伤患者的医院信托机构中的首位值班骨科外科医生和A&E部门。采用问卷调查来确定在处理重大创伤患者时通用防护措施的当前实践、经验和可用性。
总体而言,112位首位值班骨科外科医生和99个A&E部门做出了回应。使用手套(99%)和围裙(86%)的依从性良好。使用护目镜(21%)、口罩(18%)、鞋套(4%)和头罩(4%)的依从性较差。实习医生根据他们主观感知的风险水平应用通用防护措施。所有A&E部门都有手套和围裙,但其他通用防护措施的可用性较低。在实习医生中,76人报告说A&E部门并非随时都能提供所有通用防护措施。
骨科创伤团队成员在使用手套和围裙方面依从性很高,但在使用护目镜方面应提高依从性。在所有创伤场景中是否都需要使用口罩、头罩和鞋套值得怀疑。总体而言,A&E部门应更易于获取通用防护措施。A&E部门与创伤团队之间应就通用防护措施的可用性进行更好的沟通。