Williams Jane, Walter Darren, Challen Kirsty
Emergency Department, University Hospital of South Manchester, Manchester, UK.
BMC Emerg Med. 2007 Dec 20;7:20. doi: 10.1186/1471-227X-7-20.
A number of significant chemical incidents occur in the UK each year and may require Emergency Departments (EDs) to receive and manage contaminated casualties. Previously UK EDs have been found to be under-prepared for this, but since October 2005 acute hospital Trusts have had a statutory responsibility to maintain decontamination capacity. We aimed to evaluate the level of preparedness of Emergency Departments in North West England for managing chemical incidents.
A face-to-face semi-structured interview was carried out with the Nurse Manager or a nominated deputy in all 18 Emergency Departments in the Region.
16/18 departments had a written chemical incident plan but only 7 had the plan available at interview. All had a designated decontamination area but only 11 felt that they were adequately equipped. 12/18 had a current training programme for chemical incident management and 3 had no staff trained in decontamination. 13/18 could contain contaminated water from casualty decontamination and 6 could provide shelter for casualties before decontamination.
We have identified major inconsistencies in the preparedness of North West Emergency Departments for managing chemical incidents. Nationally recognized standards on incident planning, facilities, equipment and procedures need to be agreed and implemented with adequate resources. Issues of environmental safety and patient dignity and comfort should also be addressed.
英国每年都会发生多起重大化学事故，可能需要急诊科接收并处理受污染的伤员。此前发现英国的急诊科对此准备不足，但自2005年10月起，急症医院信托机构有法定责任维持去污能力。我们旨在评估英格兰西北部急诊科应对化学事故的准备水平。
对该地区所有18个急诊科的护士长或指定副手进行了面对面的半结构化访谈。
16/18的科室有书面化学事故预案，但访谈时只有7个科室有该预案。所有科室都有指定的去污区域，但只有11个科室认为其设备配备充足。12/18有当前的化学事故管理培训项目，3个科室没有接受过去污培训的工作人员。13/18能够容纳伤员去污产生的污水，6个科室能够在去污前为伤员提供庇护所。
我们发现西北部急诊科在应对化学事故的准备方面存在重大不一致。需要商定并实施全国认可的事故规划、设施、设备和程序标准，并提供充足资源。还应解决环境安全以及患者尊严和舒适度问题。
